| Organization Name: | EASTBLUFF PHYSICAL REHABILITATION, INC. |
| NPI Number: | 1073633384 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DOROTHY IRENE LUCCHESI (VICE PRESIDENT) |
| Mailing Address: | 2600 East Pacific Coast Highway Suite 240 Corona Del Mar |
| State: | CA US |
| Postal Code: | 92625 |
| Phone Number: | 9497609545 |
| Fax Number: | 7149684220 |
| NPI Enumeration Date: | 03/30/2007 |
| NPI Last Update Date: | 11/03/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2251E1200X |
| License Number: | ========= |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CA |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | Ergonomics |
| Taxonomy Definition: | |