St. Mary's Rehab Corp

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT 24314 Issued in CA

Legal business name

ST. MARY'S REHAB CORP

Practice address

11037 Acacia Pkwy
Garden Grove, CA 92840-5126

Phone

(714) 636-9980

Fax

(714) 721-3359

NPI assigned

Mar 17, 2009

Last updated

Mar 19, 2009By 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

Feliciano Ocampo III, PHYSICAL THERAPIST

Title

Cfo

Phone

(714) 626-9980

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1237248000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1237420800000",
    "number": "1902047194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11037 ACACIA PKWY",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928405126",
            "telephone_number": "714-636-9980",
            "fax_number": "714-721-3359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11037 ACACIA PKWY",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928405126",
            "telephone_number": "714-636-9980",
            "fax_number": "714-721-3359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. MARY'S REHAB CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-17",
        "last_updated": "2009-03-19",
        "status": "A",
        "authorized_official_last_name": "OCAMPO",
        "authorized_official_first_name": "FELICIANO",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "714-626-9980",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "PHYSICAL THERAPIST"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT 24314",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Garden Grove, CA
• Providers in Garden Grove, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2009; 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.