Organization
LAKEVIEW FUNCTIONAL REHAB
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. EDITH LEIGHTON MURPHY P.T. (PHYSICAL THERAPIST, OWNER)
(510) 451-5560
Entity
Organization
Contact information
Practice address
373 HANOVER AVE, OAKLAND, CA 94606-1372
(510) 451-5560
(510) 451-5564
Mailing address
373 HANOVER AVE, OAKLAND, CA 94606-1372
(510) 451-5560
(510) 451-5564
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
PT10397
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ36501Z
BLUE SHIELD PROVIDER #
CA
Enumeration date
05/02/2007
Last updated
08/22/2020
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