Provider Demographics
NPI:1851461123
Name:ENHANCE BY LINDA REIB INC.
Entity Type:Organization
Organization Name:ENHANCE BY LINDA REIB INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DELEGATED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:D
Authorized Official - Last Name:REIB
Authorized Official - Suffix:
Authorized Official - Credentials:CO
Authorized Official - Phone:916-595-1314
Mailing Address - Street 1:4811 CHIPPENDALE DR
Mailing Address - Street 2:SUITE 208
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95841-2555
Mailing Address - Country:US
Mailing Address - Phone:916-638-2508
Mailing Address - Fax:916-344-8045
Practice Address - Street 1:4811 CHIPPENDALE DR
Practice Address - Street 2:SUITE 208
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95841-2555
Practice Address - Country:US
Practice Address - Phone:916-638-2508
Practice Address - Fax:916-349-2660
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-08
Last Update Date:2018-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotistGroup - Multi-Specialty
No224900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMastectomy FitterGroup - Multi-Specialty
No225000000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotic FitterGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA5830380001Medicare ID - Type Unspecified