Provider Demographics
NPI:1912118076
Name:THE REHAB GROUP
Entity Type:Organization
Organization Name:THE REHAB GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARCY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:TRUTALLI
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:951-894-4800
Mailing Address - Street 1:40680 CALIFORNIA OAKS RD
Mailing Address - Street 2:SUITE 2A
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562-5755
Mailing Address - Country:US
Mailing Address - Phone:951-894-4800
Mailing Address - Fax:951-894-4804
Practice Address - Street 1:40680 CALIFORNIA OAKS RD
Practice Address - Street 2:SUITE 2A
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562-5755
Practice Address - Country:US
Practice Address - Phone:951-894-4800
Practice Address - Fax:951-894-4804
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2009-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ05866ZMedicare PIN