Provider Demographics
NPI:1023049970
Name:REHABONE MEDICAL GROUP, INC
Entity type:Organization
Organization Name:REHABONE MEDICAL GROUP, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:VERONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:DELGADO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-264-5570
Mailing Address - Street 1:13980 BLOSSOM HILL RD STE D
Mailing Address - Street 2:
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95032-5121
Mailing Address - Country:US
Mailing Address - Phone:408-264-5570
Mailing Address - Fax:408-264-5576
Practice Address - Street 1:13980 BLOSSOM HILL RD STE D
Practice Address - Street 2:
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-5121
Practice Address - Country:US
Practice Address - Phone:408-264-5570
Practice Address - Fax:408-264-5576
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-06
Last Update Date:2019-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACA20A6184208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC 27208OtherD.C. LICENCE
CAF14983Medicare UPIN
CAF52234Medicare UPIN
CAF36148Medicare UPIN