Provider Demographics
NPI:1558079160
Name:RTHAI REHAB, A PROFESSIONAL MEDICAL CORPORATION
Entity Type:Organization
Organization Name:RTHAI REHAB, A PROFESSIONAL MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:THAI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:408-318-5974
Mailing Address - Street 1:13089 PEYTON DR # C345
Mailing Address - Street 2:
Mailing Address - City:CHINO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91709-6018
Mailing Address - Country:US
Mailing Address - Phone:408-318-5974
Mailing Address - Fax:
Practice Address - Street 1:1130 W LA PALMA AVE
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-2803
Practice Address - Country:US
Practice Address - Phone:714-772-7480
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-11
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty