Provider Demographics
NPI:1801946264
Name:OPTIMAL REHAB ABILITIES, INC.
Entity type:Organization
Organization Name:OPTIMAL REHAB ABILITIES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:V.P.
Authorized Official - Prefix:
Authorized Official - First Name:FRED
Authorized Official - Middle Name:
Authorized Official - Last Name:MAH
Authorized Official - Suffix:
Authorized Official - Credentials:OT
Authorized Official - Phone:559-261-4100
Mailing Address - Street 1:1433 N ACACIA AVE
Mailing Address - Street 2:
Mailing Address - City:REEDLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93654-2102
Mailing Address - Country:US
Mailing Address - Phone:559-638-4034
Mailing Address - Fax:559-638-4061
Practice Address - Street 1:1433 N ACACIA AVE
Practice Address - Street 2:
Practice Address - City:REEDLEY
Practice Address - State:CA
Practice Address - Zip Code:93654-2102
Practice Address - Country:US
Practice Address - Phone:559-638-4034
Practice Address - Fax:559-638-4061
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT12805225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA=========OtherTAX ID NUMBER