Provider Demographics
NPI:1326113580
Name:SPINAL REHABILITATION MEDICAL GROUP INC
Entity Type:Organization
Organization Name:SPINAL REHABILITATION MEDICAL GROUP INC
Other - Org Name:FIRST PRIORITY MEDICAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:STEVEN
Authorized Official - Last Name:SINEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-393-2225
Mailing Address - Street 1:1441 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90404-2711
Mailing Address - Country:US
Mailing Address - Phone:310-393-2225
Mailing Address - Fax:310-393-3321
Practice Address - Street 1:1441 BROADWAY
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-2711
Practice Address - Country:US
Practice Address - Phone:310-393-2225
Practice Address - Fax:310-393-3321
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-22
Last Update Date:2012-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No335E00000XSuppliersProsthetic/Orthotic SupplierGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA6645030001Medicare NSC
CAW13999Medicare PIN
CAH48803Medicare UPIN