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Organization
H.D.P.R.G., INC
Active
Organization
H.D.P.R.G., INC
Active
Other names
Hi-Desert Physical Rehabilitation Group
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES R. LARSON (CEO)
(760) 367-1743
Entity
Organization
Contact information
Practice address
5930 ADOBE RD, TWENTYNINE PALMS, CA 92277-2356
(760) 367-1743
(760) 367-1083
Mailing address
5930 ADOBE RD, TWENTYNINE PALMS, CA 92277-2356
(760) 367-1743
(760) 367-1083
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
678082
ACN
CA
05
—
GCT000410
—
CA
05
—
GCT000411
—
CA
05
—
GPT000930
—
CA
05
—
GPT000931
—
CA
05
—
GSP000540
—
CA
05
—
GSP000541
—
CA
01
—
ZZZ07514Z
BLUE SHIELD
CA
01
—
ZZZ07515Z
BLUE SHIELD
CA
01
—
ZZZ08125Z
BLUE SHIELD
CA
01
—
ZZZ08126Z
BLUE SHIELD
CA
01
—
ZZZ08135Z
BLUE SHIELD
CA
01
—
ZZZ08136Z
BLUE SHIELD
CA
Enumeration date
01/16/2007
Last updated
09/11/2025
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