Organization
COLLIER REHABILITATION SYSTEMS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN G RUSSELL JR. C.P.O. (PRESIDENT)
(925) 943-1119
Entity
Organization
Contact information
Practice address
3161 PUTNAM BLVD, PLEASANT HILL, CA 94523-4650
(925) 943-1119
(925) 943-2493
Mailing address
3161 PUTNAM BLVD, PLEASANT HILL, CA 94523-4650
(925) 943-1119
(925) 943-2493
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
0000026982
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
XB0009910
MEDI-CAL
CA
Enumeration date
12/04/2006
Last updated
08/14/2007
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