Organization
CENTER FOR INDEPENDENT REHABILITATIVE SERVICES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EDDIE G ROGERS CPO (PRESIDENT)
(209) 845-8231
Entity
Organization
Contact information
Practice address
430 40TH STREET, 1ST FLOOR, OAKLAND, CA 94609-2522
(510) 653-9834
(510) 653-9037
Mailing address
693 HI TECH PARKWAY, OAKDALE, CA 95361
(209) 845-8231
(209) 845-2883
Taxonomy
Speciality
Code
Description
License number
State
225000000X
Orthotic Fitter
—
—
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GXC000860
—
CA
Enumeration date
07/25/2006
Last updated
12/29/2010
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