Provider Demographics
NPI:1578935391
Name:RECOVERY & REHABILITATION MEDICAL GROUP, P.C.
Entity Type:Organization
Organization Name:RECOVERY & REHABILITATION MEDICAL GROUP, P.C.
Other - Org Name:RECOVERY & REHABILITATION MEDICAL GROUP, P.C.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MELANIE
Authorized Official - Middle Name:WILLIS
Authorized Official - Last Name:LORENZEN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:714-442-0985
Mailing Address - Street 1:17901 VON KARMAN AVE
Mailing Address - Street 2:600
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92614-6297
Mailing Address - Country:US
Mailing Address - Phone:714-442-0985
Mailing Address - Fax:
Practice Address - Street 1:17901 VON KARMAN AVE
Practice Address - Street 2:600
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92614-6297
Practice Address - Country:US
Practice Address - Phone:714-442-0985
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-21
Last Update Date:2015-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty