Provider Demographics
NPI:1831234822
Name:MONARCH REHAB INC
Entity type:Organization
Organization Name:MONARCH REHAB INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:F
Authorized Official - Last Name:WALSH
Authorized Official - Suffix:
Authorized Official - Credentials:RPT
Authorized Official - Phone:818-997-7771
Mailing Address - Street 1:2222 FOOTHILL BLVD
Mailing Address - Street 2:E-553
Mailing Address - City:LA CANADA
Mailing Address - State:CA
Mailing Address - Zip Code:91011-1456
Mailing Address - Country:US
Mailing Address - Phone:818-997-7771
Mailing Address - Fax:818-997-7772
Practice Address - Street 1:6742 VAN NUYS BLVD
Practice Address - Street 2:SUITE 209
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91405-4611
Practice Address - Country:US
Practice Address - Phone:818-997-7771
Practice Address - Fax:818-997-7772
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA102965332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADME03168FMedicaid
CADME03168FMedicaid