Provider Demographics
NPI:1770836215
Name:360 REHABILITATION INC
Entity Type:Organization
Organization Name:360 REHABILITATION INC
Other - Org Name:RA PHYSICAL THERAPY AND REHABILITATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALEEM
Authorized Official - Middle Name:
Authorized Official - Last Name:DINANI
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:310-597-9430
Mailing Address - Street 1:910 1/2 S ROBERTSON BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90035-1602
Mailing Address - Country:US
Mailing Address - Phone:310-657-7220
Mailing Address - Fax:310-657-7221
Practice Address - Street 1:910 1/2 S ROBERTSON BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90035-1602
Practice Address - Country:US
Practice Address - Phone:310-657-7220
Practice Address - Fax:310-657-7221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-22
Last Update Date:2012-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty