Organization
TOTAL REHABILITATION MEDICINE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALIASGHAR MATIN MD (DIRECTOR)
(818) 547-9870
Entity
Organization
Contact information
Practice address
5635 CAHUENGA BLVD, NORTH HOLLYWOOD, CA 91601-2104
(818) 308-7450
(818) 308-7795
Mailing address
1407 HILLSIDE DR, GLENDALE, CA 91208-2416
(818) 547-9870
(818) 547-9870
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
A97751
CA
225100000X
Physical Therapist
PT 12456
CA
291U00000X
Clinical Medical Laboratory
MTA44130
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1679730923
MEDI-CAL
CA
Enumeration date
05/22/2008
Last updated
11/06/2014
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