Provider Demographics
NPI:1780990986
Name:TOTAL REHAB INSTITUTE INC.
Entity type:Organization
Organization Name:TOTAL REHAB INSTITUTE INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:WASSERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-860-9646
Mailing Address - Street 1:50 N LA CIENEGA BLVD
Mailing Address - Street 2:SUITE #201
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-2227
Mailing Address - Country:US
Mailing Address - Phone:310-860-9646
Mailing Address - Fax:
Practice Address - Street 1:1030 S ARROYO PKWY
Practice Address - Street 2:SUITE #140
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-3214
Practice Address - Country:US
Practice Address - Phone:626-593-2283
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-25
Last Update Date:2010-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT16294174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW14812Medicare PIN