Provider Demographics
NPI:1811266935
Name:REDWOOD ELECTROTHERAPY, LLC
Entity type:Organization
Organization Name:REDWOOD ELECTROTHERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORTHOPEDIC SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:ABELES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:510-856-4350
Mailing Address - Street 1:21060 REDWOOD RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CASTRO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94546-5931
Mailing Address - Country:US
Mailing Address - Phone:510-856-4350
Mailing Address - Fax:510-581-6240
Practice Address - Street 1:21060 REDWOOD RD
Practice Address - Street 2:SUITE 200
Practice Address - City:CASTRO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94546-5931
Practice Address - Country:US
Practice Address - Phone:510-856-4350
Practice Address - Fax:510-581-6240
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-19
Last Update Date:2014-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA201127110253332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies