Provider Demographics
NPI:1164719803
Name:PREHAB SOLUTIONS
Entity Type:Organization
Organization Name:PREHAB SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:PENDON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:310-474-4721
Mailing Address - Street 1:8421 WILSHIRE BLVD
Mailing Address - Street 2:STE. 104
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-3225
Mailing Address - Country:US
Mailing Address - Phone:310-474-4721
Mailing Address - Fax:310-474-4014
Practice Address - Street 1:8421 WILSHIRE BLVD
Practice Address - Street 2:STE. 104
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-3225
Practice Address - Country:US
Practice Address - Phone:310-474-4721
Practice Address - Fax:310-474-4014
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-01
Last Update Date:2011-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC30452111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty