Jeremiah Harrison

 
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 From icampusano 1.855.355.8555 Tue Oct 4 18:40:18 2022 EDT Page 26 of 106 
 Ronald Fujimoto DO 
 Physical Medicine and Rehabilitation 
 Apr 01, 2019 
 RehabOne 
 RehabOne Programs 
 - 
 PRESCRIPTION- Industrial 
 PATIENT NAME: Jeremiah Harrison
 exm date: 18-08-18
 Supervising Physician: Ronald Fujimoto DO 
 Performing Provider: Dr Luis Fuentes MD 
 Krewark 
 MD 
 Dr Luis Fuentes MD 
 Today's Date: 04/01/2019 
 RehabOne Medical Group, Inc. 
 Mailing Address: 13980 Blossom Hill Rd. Ste. B, Los Gatos, CA 95032 
 Phone: 455-455-8550 Fax: 455-455-0555 
 Providers' CA License Numbers: 
 Michael Post, MD - G75517 
 Ronald Fujimoto, DO - 20A6554 
 Allen Kaisler-Meza, MD - G74556 
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