Provider Demographics
NPI:1952620437
Name:REISS PHYSICAL THERAPY & REHAB, INC.
Entity Type:Organization
Organization Name:REISS PHYSICAL THERAPY & REHAB, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:A
Authorized Official - Last Name:REISS
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT, OCS
Authorized Official - Phone:323-965-7713
Mailing Address - Street 1:432 N PALM DR
Mailing Address - Street 2:207
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90210-3951
Mailing Address - Country:US
Mailing Address - Phone:323-965-7713
Mailing Address - Fax:323-978-6860
Practice Address - Street 1:432 N PALM DRIVE
Practice Address - Street 2:207
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-3951
Practice Address - Country:US
Practice Address - Phone:323-965-7713
Practice Address - Fax:323-978-6860
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-24
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA29826225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty