# LOOMIS GANG REHAB INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1760361794
- **Authorized official:** COLETTE THILKEN (MANAGER)
- **Authorized official phone:** (949) 533-0319

## Contact information

- **Practice address:** 1130 W LA PALMA AVE, ANAHEIM, CA 92801-2803
- **Practice address phone:** (714) 772-7480
- **Mailing address:** 6475 E PACIFIC COAST HWY \# 746, LONG BEACH, CA 90803-4201
- **Mailing address phone:** (949) 533-0319

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |
| 208VP0000X | Pain Medicine Physician | — | NULL | — |
| 208VP0000X | Pain Medicine Physician | — | — | — |

## Other

- **Enumeration date:** 09/02/2025
- **Last updated:** 09/02/2025