NPIMap

Organization Active NPI

Advance Rehab Services, Inc

  • Neurorehabilitation Occupational Therapist
  • San Dimas, CA
National Provider Identifier
1801430061
Registry record updated Apr 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurorehabilitation Occupational TherapistTaxonomy code 225XN1300X
Legal business name
ADVANCE REHAB SERVICES, INC
Practice address
350 Nugget CT
San Dimas, CA 91773-2312
Phone
(818) 314-5774
Fax
(818) 484-2146
NPI assigned
Oct 31, 2019
Last updated
Apr 8, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Manoj K Parida, OTRNPI 1972079457
Title
President
Phone
(818) 314-5774

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Physical Therapist 2251G0304X
Human Factors Physical Therapist 2251H1300X
Orthopedic Physical Therapist 2251X0800X
Occupational Therapist 225X00000X
Human Factors Occupational Therapist 225XH1300X
Neurorehabilitation Occupational Therapist 225XN1300X Primary
Speech-Language Pathologist 235Z00000X
Physical Rehabilitation Occupational Therapist 225XP0019X

Addresses

Primary practice location

350 Nugget CT
San Dimas, CA 91773-2312

Mailing address

350 Nugget CT
San Dimas, CA 91773-2312
Phone (818) 314-5774

Other identifiers 1

IdentifierTypeStateIssuer
OT817OtherCALICENSE

National Provider Directory

National Provider Directory

Locations

451 W Bonita Ave
Ste 10
San Dimas, CA 91773

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1572480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586304000000",
    "number": "1801430061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 NUGGET CT",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "917732312",
            "telephone_number": "818-314-5774",
            "fax_number": "818-484-2146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 NUGGET CT",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "917732312",
            "telephone_number": "818-314-5774",
            "fax_number": "818-484-2146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCE REHAB SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-31",
        "last_updated": "2020-04-08",
        "certification_date": "2020-04-08",
        "status": "A",
        "authorized_official_last_name": "PARIDA",
        "authorized_official_first_name": "MANOJ",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-314-5774",
        "authorized_official_credential": "OTR"
    },
    "taxonomies": [
        {
            "code": "2251G0304X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Geriatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2251H1300X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Human Factors",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XH1300X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Human Factors",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XN1300X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Neurorehabilitation",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XP0019X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "OT817",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Dimas, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.