Organization
FORTUNA REHABILITATION
Active
Other names
Perspectives in Rehab
Organization subpart
No
Provider details
NPI number
Authorized official
DONNELLA GOODWIN MBA (CFO, COO)
(619) 575-0157
Entity
Organization
Contact information
Practice address
2648 MAIN ST, SUITE BC, CHULA VISTA, CA 91911-4664
(619) 575-0157
(619) 575-0053
Mailing address
2648 MAIN ST, SUITE BC, CHULA VISTA, CA 91911-4664
(619) 575-0157
(619) 575-0053
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
056863
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PT0051200
—
CA
Enumeration date
01/11/2007
Last updated
08/31/2007
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