1. Home
  2. Directory
  3. California
  4. San Diego
  5. Clinic Center
  6. NPI Profile

SAN DIEGO REHAB
NPI 1639907272
Clinic/Center - Rehabilitation, Substance Use Disorder in San Diego, CA

Active since July 24, 2024CLIA 05D2316809 · Waiver
430 NUTMEG ST STE 200, SAN DIEGO, CA 92103(310) 343-8684 Get Directions Write a Review

NPPES record last updated: August 7, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Aug 7, 2024, Jul 24, 2024 (2 updates tracked since 2024).

About San Diego Rehab NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SAN DIEGO REHAB (NPI 1639907272) is a healthcare organization registered as a rehabilitation, substance use disorder in San Diego, California and active in the NPI registry since July 2024. The organization holds a CLIA Waiver certificate valid through January 12, 2027 and lists Nathan Young, Manager, as its authorized official.

NPPES Registry Identity

NPI1639907272
Entity TypeOrganization
Primary Taxonomy261QR0405X
Legal Business NameSAN DIEGO REHAB
Location Address430 NUTMEG ST STE 200San Diego, CA 92103-6261
Mailing Address430 Nutmeg St Ste 200San Diego, CA 92103-6261
Phone(310) 343-8684
Organization SubpartNo
Authorized OfficialNathan YoungManager · (310) 343-8684
Enumeration DateJuly 24, 2024
Last NPPES UpdateAugust 7, 20242 updates tracked since enumeration
NPPES CertifiedAugust 7, 2024
✔ NPI 1639907272 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Rehabilitation, Substance Use DisorderAmbulatory Health Care Facilities
Taxonomy Code261QR0405X
430 NUTMEG ST STE 200, San Diego, CA 92103
Open in Google Maps ↗

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D2316809

San Diego Rehab LLC · San Diego, CA
Active · expires Jan 12, 2027
CLIA Number05D2316809
Laboratory TypeIop
Certificate Effective DateJanuary 13, 2025
Certificate Expiration DateJanuary 12, 2027
Laboratory DirectorSydney Abramson
Laboratory Phone(310) 774-1670
Laboratory LocationSan Diego Rehab LLC430 Nutmeg St Ste 200, San Diego, CA 92103
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is San Diego Rehab's NPI number?

The NPI number for San Diego Rehab is 1639907272. It was assigned to this organization in the NPPES registry on July 24, 2024.

Where is San Diego Rehab located?

San Diego Rehab is located at 430 Nutmeg St Ste 200, San Diego, CA 92103. The listed phone number is (310) 343-8684.

What is San Diego Rehab's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rehabilitation, Substance Use Disorder, with taxonomy code 261QR0405X.

Does San Diego Rehab hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D2316809) is associated with this NPI, valid through January 12, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for San Diego Rehab was last updated on August 7, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.