Provider Demographics
NPI:1093911414
Name:CHADAM ASSOCIATES INC, A PHYSICAL THERAPY CORPORATION
Entity Type:Organization
Organization Name:CHADAM ASSOCIATES INC, A PHYSICAL THERAPY CORPORATION
Other - Org Name:WESTERN REHABILITATION ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:I
Authorized Official - Last Name:TAKII
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:661-763-4194
Mailing Address - Street 1:3801 BUCK OWENS BLVD #116
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93308
Mailing Address - Country:US
Mailing Address - Phone:661-327-4685
Mailing Address - Fax:661-327-1959
Practice Address - Street 1:337 S. 10TH STREET
Practice Address - Street 2:#G
Practice Address - City:TAFT
Practice Address - State:CA
Practice Address - Zip Code:93268-3300
Practice Address - Country:US
Practice Address - Phone:661-763-4194
Practice Address - Fax:661-763-5792
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA261QP2000X
261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA=========OtherFED TAX ID