Provider Demographics
NPI:1457439499
Name:RHEUMATOLOGICAL REHAB MEDICAL GROUP
Entity Type:Organization
Organization Name:RHEUMATOLOGICAL REHAB MEDICAL GROUP
Other - Org Name:ARTHRITIS & BACK PAIN CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT AND MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:L
Authorized Official - Last Name:SWEZEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-394-1113
Mailing Address - Street 1:1328 16TH STREET
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90404
Mailing Address - Country:US
Mailing Address - Phone:310-394-1113
Mailing Address - Fax:310-395-3218
Practice Address - Street 1:1328 16TH STREET
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404
Practice Address - Country:US
Practice Address - Phone:310-394-1113
Practice Address - Fax:310-395-3218
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Multi-Specialty
Not Answered208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
Not Answered2471B0102XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistBone DensitometryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
W5147Medicare ID - Type Unspecified
A19222Medicare UPIN