Provider Demographics
NPI:1902854854
Name:FEMA PHYSICAL THERAPY CENTER INC
Entity Type:Organization
Organization Name:FEMA PHYSICAL THERAPY CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FATHEME
Authorized Official - Middle Name:R
Authorized Official - Last Name:RASTAWAN
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:714-774-6000
Mailing Address - Street 1:1751 W ROMNEYA DR
Mailing Address - Street 2:SUITE M
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92801-1815
Mailing Address - Country:US
Mailing Address - Phone:714-774-6000
Mailing Address - Fax:714-774-6100
Practice Address - Street 1:1751 W ROMNEYA DR
Practice Address - Street 2:SUITE M
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-1815
Practice Address - Country:US
Practice Address - Phone:714-774-6000
Practice Address - Fax:714-774-6100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-04
Last Update Date:2013-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22945261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy