Provider Demographics
NPI:1942629605
Name:ALTERNATIVE REHAB
Entity Type:Organization
Organization Name:ALTERNATIVE REHAB
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:MR
Authorized Official - First Name:ELMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:HEIMANSON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:310-916-7177
Mailing Address - Street 1:8950 W OLYMPIC BLVD STE 373
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-3565
Mailing Address - Country:US
Mailing Address - Phone:310-916-7177
Mailing Address - Fax:323-214-7938
Practice Address - Street 1:8950 W OLYMPIC BLVD STE 373
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-3565
Practice Address - Country:US
Practice Address - Phone:310-916-7177
Practice Address - Fax:323-214-7938
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-10
Last Update Date:2014-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA40748208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty