Provider Demographics
NPI:1063423077
Name:BADKE MEDICAL & REHABILITATION, A MEDICAL CORPORATION
Entity type:Organization
Organization Name:BADKE MEDICAL & REHABILITATION, A MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:BADKE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:831-424-4886
Mailing Address - Street 1:945 BLANCO CIR STE B
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93901-4421
Mailing Address - Country:US
Mailing Address - Phone:831-424-4886
Mailing Address - Fax:831-424-5224
Practice Address - Street 1:945 BLANCO CIR STE B
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-4421
Practice Address - Country:US
Practice Address - Phone:831-424-4886
Practice Address - Fax:831-424-5224
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-11
Last Update Date:2009-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA55096208100000X
CAA55052207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty