Provider Demographics
NPI:1790270536
Name:RABAJA, GEORGE (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:
Last Name:RABAJA
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:746 S BURLINGTON AVE APT 129
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90057-5300
Mailing Address - Country:US
Mailing Address - Phone:121-350-0919
Mailing Address - Fax:
Practice Address - Street 1:2362 MORSE AVE
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92614-6234
Practice Address - Country:US
Practice Address - Phone:949-863-9103
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-25
Last Update Date:2018-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR62788225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist