Organization
MOUNTAIN VIEW REHABILITATION MEDICAL ASSOCIATES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DEBORAH LEA THOMPSON (BUSINESS MANAGER)
(530) 477-6283
Entity
Organization
Contact information
Practice address
380 SIERRA COLLEGE DR, STE 200, GRASS VALLEY, CA 95945-5081
(530) 477-0893
(530) 477-1450
Mailing address
10556 COMBIE RD, #6439, AUBURN, CA 95602-8908
(530) 268-4664
(530) 268-4666
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DA2353
MEDICARE RR GROUP
CA
01
—
ZZZ07115Z
BLUE SHIELD GROUP
CA
Enumeration date
09/20/2006
Last updated
11/29/2012
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