Provider Demographics
NPI:1790008589
Name:BRAVA REHAB SERVICES, INC
Entity Type:Organization
Organization Name:BRAVA REHAB SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MISS
Authorized Official - First Name:CRISTINA
Authorized Official - Middle Name:CLAUDIA
Authorized Official - Last Name:POPESCU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-327-2332
Mailing Address - Street 1:401 S BARRINGTON AVE
Mailing Address - Street 2:# 204
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90049-6406
Mailing Address - Country:US
Mailing Address - Phone:323-327-2332
Mailing Address - Fax:310-472-2372
Practice Address - Street 1:401 S BARRINGTON AVE
Practice Address - Street 2:# 204
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90049-6406
Practice Address - Country:US
Practice Address - Phone:323-327-2332
Practice Address - Fax:310-472-2372
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-08
Last Update Date:2011-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT33305261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy