| Gateway Rehab & Wellness Center, Inc. | |
|
24002 Via Fabricante, Suite 501, Mission Viejo, CA 92691-3901 | |
| (949) 454-8811 | |
| (949) 454-8833 |
| Full Name | Gateway Rehab & Wellness Center, Inc. |
|---|---|
| Type | Facility |
| Speciality | Specialist |
| Location | 24002 Via Fabricante, Mission Viejo, California |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184746927 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | DC-28755 (California) | Secondary |
| 111N00000X | Chiropractor | DC-28726 (California) | Secondary |
| 174400000X | Specialist | G060299 (California) | Primary |
| Provider Name | John W Schlingman |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1720141211 PECOS PAC ID: 5597711747 Enrollment ID: I20050330000875 |
| Provider Name | William R Carr |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1609092501 PECOS PAC ID: 1557375672 Enrollment ID: I20060127000541 |
| Provider Name | Vinod Malhotra |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1366500514 PECOS PAC ID: 9335225176 Enrollment ID: I20080319000611 |
| Provider Name | Fortunato D. Azoulay |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1053560276 PECOS PAC ID: 9133260722 Enrollment ID: I20100105000102 |
| Provider Name | Victor R Rafa |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1952423618 PECOS PAC ID: 5698802064 Enrollment ID: I20100723000752 |
| Provider Name | Ashlee R Denaro |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1265773048 PECOS PAC ID: 9638308802 Enrollment ID: I20140210001749 |
| Provider Name | Jason B Stoddard |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1104219690 PECOS PAC ID: 1254693666 Enrollment ID: I20180323001066 |
| Provider Name | Haleh Dejam |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275107310 PECOS PAC ID: 8325426661 Enrollment ID: I20220527001664 |
| Mailing Address | Practice Location Address |
|---|---|
| Gateway Rehab & Wellness Center, Inc. 24002 Via Fabricante, Suite 501, Mission Viejo, CA 92691-3901 Ph: (949) 454-8811 | Gateway Rehab & Wellness Center, Inc. 24002 Via Fabricante, Suite 501, Mission Viejo, CA 92691-3901 Ph: (949) 454-8811 |