Provider Demographics
NPI:1861557522
Name:IMPAQ REHABILITATION SPECIALISTS, INC
Entity type:Organization
Organization Name:IMPAQ REHABILITATION SPECIALISTS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CESAR
Authorized Official - Middle Name:
Authorized Official - Last Name:ARADA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-548-0000
Mailing Address - Street 1:178 DENSLOWE DR
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94132-2035
Mailing Address - Country:US
Mailing Address - Phone:415-548-0000
Mailing Address - Fax:415-333-6231
Practice Address - Street 1:178 DENSLOWE DR
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94132-2035
Practice Address - Country:US
Practice Address - Phone:415-548-0000
Practice Address - Fax:415-333-6231
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-23
Last Update Date:2009-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA398166225400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation PractitionerGroup - Multi-Specialty