Provider Demographics
NPI:1063693885
Name:REHABILITATION MANAGEMENT SYSTEMS
Entity type:Organization
Organization Name:REHABILITATION MANAGEMENT SYSTEMS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:JEROME
Authorized Official - Last Name:HENRY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:916-927-3422
Mailing Address - Street 1:648 NORTHFIELD DR
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95833-2442
Mailing Address - Country:US
Mailing Address - Phone:916-927-3422
Mailing Address - Fax:916-927-1245
Practice Address - Street 1:648 NORTHFIELD DR
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95833-2442
Practice Address - Country:US
Practice Address - Phone:916-927-3422
Practice Address - Fax:916-927-1245
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-20
Last Update Date:2019-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA40497174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ01481ZMedicare PIN