Provider Demographics
NPI:1205187366
Name:HEART CARE AND REHABILITATION CENTER
Entity Type:Organization
Organization Name:HEART CARE AND REHABILITATION CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:CHINEDU
Authorized Official - Last Name:AMAJOYI
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:909-644-6444
Mailing Address - Street 1:319 S PARK AVE STE D
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:CA
Mailing Address - Zip Code:91766-1503
Mailing Address - Country:US
Mailing Address - Phone:909-644-6444
Mailing Address - Fax:
Practice Address - Street 1:319 S PARK AVE STE D
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91766-1503
Practice Address - Country:US
Practice Address - Phone:909-644-6444
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-28
Last Update Date:2012-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18731261QC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health