Provider Demographics
NPI:1770039703
Name:KAWEAH REHAB GROUP INC
Entity Type:Organization
Organization Name:KAWEAH REHAB GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:ASHRAF
Authorized Official - Middle Name:
Authorized Official - Last Name:GHALY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:559-300-9777
Mailing Address - Street 1:PO BOX 6236
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93290-6236
Mailing Address - Country:US
Mailing Address - Phone:559-300-9777
Mailing Address - Fax:559-750-4777
Practice Address - Street 1:840 S AKERS ST
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93277-8309
Practice Address - Country:US
Practice Address - Phone:559-300-9777
Practice Address - Fax:559-750-4777
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-30
Last Update Date:2016-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1438832081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Single Specialty