Provider Demographics
NPI:1972744944
Name:CONTINUUM GROUP WEST LLC
Entity Type:Organization
Organization Name:CONTINUUM GROUP WEST LLC
Other - Org Name:CONTINUUM ADVANCED HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:WEINBERG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-990-9095
Mailing Address - Street 1:8230 LEESBURG PIKE STE 740
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-2641
Mailing Address - Country:US
Mailing Address - Phone:703-506-0123
Mailing Address - Fax:
Practice Address - Street 1:2702 N 44TH ST
Practice Address - Street 2:STE 101A
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85008-1583
Practice Address - Country:US
Practice Address - Phone:480-990-9095
Practice Address - Fax:480-941-1233
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-20
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4858111N00000X
AZ32912208100000X
AZ6029261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ457222Medicaid
AZZ133465Medicare PIN