Pacific Therapy and Rehab, Inc

Primary specialty

Rehabilitation Clinic/CenterTaxonomy code 261QR0400X

License

OT5979 Issued in CA

Legal business name

PACIFIC THERAPY AND REHAB, INC

Practice address

39159 Paseo Padre Pkwy
Suite 111
Fremont, CA 94538-1608

Phone

(510) 505-9800

Fax

(510) 505-9880

NPI assigned

Dec 29, 2006

Last updated

Jul 31, 2008By 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

Robert Chan

Title

Vice President

Phone

(408) 832-9656

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA2 enrollments

Enrollment records 2

Tax ID family

Pacific Therapy and Rehab2 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.

• Pacific Therapy and Rehab, Inc

  • Occupational Therapist
  • San Jose, CA
  • NPI 1598820862
  NPD tax ID

Locations

Practitioners 1

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.

• Lisa S Chan, O.T.R.

  • Occupational Therapist
  • San Jose, CA
  • NPI 1770649352
  Medicare reassignment NPD

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

{
    "created_epoch": "1167350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217462400000",
    "number": "1962568493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 610638",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951610638",
            "telephone_number": "408-832-9656",
            "fax_number": "510-505-9880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39159 PASEO PADRE PKWY",
            "address_2": "SUITE 111",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945381608",
            "telephone_number": "510-505-9800",
            "fax_number": "510-505-9880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC THERAPY AND REHAB, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-29",
        "last_updated": "2008-07-31",
        "status": "A",
        "authorized_official_last_name": "CHAN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "408-832-9656"
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "CA",
            "license": "OT5979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Summer Isabella Pacheco
• Pacific Bay Pediatric Dentistry
• Pacific Care Facilities LLC
• Pacific Neurophysiologists LLC
• Pacific Ocean Behavioral Health
• Angelo D Padavana
• Gisela Padilla de Luna
• Adrianna Padilla
• Araceli Padilla
• Marisol Padilla, LCSW

• Rehabilitation Clinic/Center in Fremont, CA
• Providers in Fremont, CA by specialty
• Rehabilitation Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.