Provider Demographics
NPI:1457333908
Name:BURGER PHYSICAL THERAPY AND REHABILITATION AGENCY INC
Entity Type:Organization
Organization Name:BURGER PHYSICAL THERAPY AND REHABILITATION AGENCY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:K
Authorized Official - Last Name:BURGER
Authorized Official - Suffix:
Authorized Official - Credentials:PT, MPA
Authorized Official - Phone:916-983-5915
Mailing Address - Street 1:1301 E BIDWELL ST
Mailing Address - Street 2:#201
Mailing Address - City:FOLSOM
Mailing Address - State:CA
Mailing Address - Zip Code:95630-3452
Mailing Address - Country:US
Mailing Address - Phone:916-983-5915
Mailing Address - Fax:916-983-5925
Practice Address - Street 1:1301 E BIDWELL ST
Practice Address - Street 2:#101
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630-3452
Practice Address - Country:US
Practice Address - Phone:916-983-5915
Practice Address - Fax:916-983-5925
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-18
Last Update Date:2014-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA056536Medicare Oscar/Certification