Ezra Medical Rehab & Recovery Center

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

EZRA MEDICAL REHAB & RECOVERY CENTER

Practice address

429 Murillo Dr
Stockton, CA 95207-2226

Phone

(716) 371-1945

NPI assigned

Sep 4, 2025

Last updated

Sep 4, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Tristan Mireles

Title

Ceo

Phone

(716) 671-1945

Specialties & licenses 1

Addresses

Tax ID family

Ceo2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Ezra Medical Rehab & Recovery Center

  dba Ceo

  • Durable Medical Equipment & Medical Supplies
  • Stockton, CA
  • NPI 1437039864
  NPD tax ID

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

{
    "created_epoch": "1756944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756944000000",
    "number": "1851271514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "429 MURILLO DR",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952072226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "429 MURILLO DR",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952072226",
            "telephone_number": "716-371-1945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EZRA MEDICAL REHAB & RECOVERY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-04",
        "last_updated": "2025-09-04",
        "certification_date": "2025-09-04",
        "status": "A",
        "authorized_official_last_name": "MIRELES",
        "authorized_official_first_name": "TRISTAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "716-671-1945"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Excell E.N.T. Medical Group, Inc.
• Eyecheck Optometry Inc
• Crystal Eze, PMHNP-BC
• Ekenedilichukwu Ezenwaka, NP
• Ezra Medical Rehab & Recovery Center (Ceo)
• F Karl Gregorius M.D., Inc.
• Todd Fabian, MA, BCBA
• Karen M Fabreo-Hittle, P.T.
• Katie Denise Faccini
• Ciarra Monique Fackender

• Durable Medical Equipment & Medical Supplies in Stockton, CA
• Providers in Stockton, CA by specialty
• Durable Medical Equipment & Medical Supplies in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2025; 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.