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Organization
SUNNYSIDE REHAB INC
Active
Organization
SUNNYSIDE REHAB INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LUDE REGINE RICARD MSPT (PRESIDENT)
(619) 621-9215
Entity
Organization
Contact information
Practice address
5703 OBERLIN DR STE 308, SAN DIEGO, CA 92121-1743
(858) 547-9101
(866) 666-7390
Mailing address
5703 OBERLIN DR STE 308, SAN DIEGO, CA 92121-1743
(619) 621-9215
(866) 666-7390
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
33814
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT33814
PT LICENSE NUMBER
CA
Enumeration date
02/01/2012
Last updated
12/17/2018
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