Provider Demographics
NPI:1952428443
Name:PACIFIC RIM REHABILITATION CENTER
Entity type:Organization
Organization Name:PACIFIC RIM REHABILITATION CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JINJIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CHEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-436-5522
Mailing Address - Street 1:PO BOX 4626
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94040-0626
Mailing Address - Country:US
Mailing Address - Phone:408-436-5522
Mailing Address - Fax:408-436-8777
Practice Address - Street 1:55 N 13TH ST
Practice Address - Street 2:SUITE A
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95112-3528
Practice Address - Country:US
Practice Address - Phone:408-436-5522
Practice Address - Fax:408-436-8777
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2020-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC7085171100000X
CAPT22207225100000X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAP14737Medicare UPIN
CAZZZ24111ZMedicare PIN