Provider Demographics
NPI:1821556689
Name:TOP TIER REHAB & PERFORMANCE
Entity Type:Organization
Organization Name:TOP TIER REHAB & PERFORMANCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST/ATHLETIC TRAINER
Authorized Official - Prefix:
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:YORAY
Authorized Official - Last Name:WANG
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT, ATC
Authorized Official - Phone:909-569-3903
Mailing Address - Street 1:45 TULARE DR
Mailing Address - Street 2:
Mailing Address - City:ALISO VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92656-8084
Mailing Address - Country:US
Mailing Address - Phone:909-569-3903
Mailing Address - Fax:
Practice Address - Street 1:45 TULARE DR
Practice Address - Street 2:
Practice Address - City:ALISO VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92656-8084
Practice Address - Country:US
Practice Address - Phone:909-569-3903
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-11
Last Update Date:2019-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation