Organization
ADVANCE REHAB SERVICES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MANOJ K PARIDA OTR (PRESIDENT)
(818) 314-5774
Entity
Organization
Contact information
Practice address
350 NUGGET CT, SAN DIMAS, CA 91773-2312
(818) 314-5774
(818) 484-2146
Mailing address
350 NUGGET CT, SAN DIMAS, CA 91773-2312
(818) 314-5774
(818) 484-2146
Taxonomy
Speciality
Code
Description
License number
State
2251G0304X
Geriatric Physical Therapist
—
—
2251H1300X
Human Factors Physical Therapist
—
—
2251X0800X
Orthopedic Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
225XH1300X
Human Factors Occupational Therapist
—
—
225XN1300X
Neurorehabilitation Occupational Therapist
Primary
—
—
225XP0019X
Physical Rehabilitation Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OT817
LICENSE
CA
Enumeration date
10/31/2019
Last updated
04/08/2020
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