Provider Demographics
NPI:1194905166
Name:AMERICAN INTERNATIONAL REHABILITATION SPECIALISTS, INC
Entity type:Organization
Organization Name:AMERICAN INTERNATIONAL REHABILITATION SPECIALISTS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:NELSON
Authorized Official - Middle Name:CALMON
Authorized Official - Last Name:CORNEAU
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:818-481-2373
Mailing Address - Street 1:16108 PARTHENIA ST
Mailing Address - Street 2:
Mailing Address - City:NORTH HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91343-4808
Mailing Address - Country:US
Mailing Address - Phone:818-481-2373
Mailing Address - Fax:818-830-4188
Practice Address - Street 1:16108 PARTHENIA ST
Practice Address - Street 2:
Practice Address - City:NORTH HILLS
Practice Address - State:CA
Practice Address - Zip Code:91343-4808
Practice Address - Country:US
Practice Address - Phone:818-481-2373
Practice Address - Fax:818-830-4188
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-07
Last Update Date:2007-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
W15382Medicare PIN