Organization Name: | LAGUNA BEACH REHAB, INC. AND PHYSICAL THERAPY |
NPI Number: | 1164466785 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CAROL M. FRACALOSY (OWNER) |
Mailing Address: | 2600 E. Pacific Coast Highway Ste. 240 Corona Del Mar |
State: | CA US |
Postal Code: | 92625 |
Phone Number: | 9496402121 |
Fax Number: | 9496402631 |
NPI Enumeration Date: | 06/15/2006 |
NPI Last Update Date: | 07/23/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261Q00000X |
License Number: | BT00015281 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | |
Taxonomy Definition: | A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |