Provider Demographics
NPI:1790896579
Name:ABILITY REHABILITATION SPECIALISTS
Entity Type:Organization
Organization Name:ABILITY REHABILITATION SPECIALISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HOM
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:858-456-2114
Mailing Address - Street 1:737 PEARL ST
Mailing Address - Street 2:SUITE 108
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-0056
Mailing Address - Country:US
Mailing Address - Phone:858-456-2114
Mailing Address - Fax:858-456-2103
Practice Address - Street 1:737 PEARL ST
Practice Address - Street 2:SUITE 108
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-0056
Practice Address - Country:US
Practice Address - Phone:858-456-2114
Practice Address - Fax:858-456-2103
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2011-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 23458225100000X
CA225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty