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NPI Code Detail

MEDICARE: CALIFORNIA SPORTS PHYSICAL THERAPY CENTERS, INC.

MEDICARE: CALIFORNIA SPORTS PHYSICAL THERAPY CENTERS, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist
2225100000XPhysical Therapist

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1ZZZ66047ZOTHERCABLUESHIELD
24475238OTHERCACIGNA
3183888005OTHERCADOL

General Provider Information

NPI Number : 1235111741
Entity Type Code : Organization
Provider Name (Legal Business Name) : CALIFORNIA SPORTS PHYSICAL THERAPY CENTERS, INC.
Provider Business Mailing Address
First Line : 2600 DALLAS PKWY STE 290
Second Line :
City : FRISCO
State : TX
Zip : 75034-7493
Country : US
Telephone Number : 945-260-0010
Fax Number :
Provider Business Practice Location Address
First Line : 5910 PACIFIC AVE
Second Line :
City : STOCKTON
State : CA
Zip : 95207-4704
Country : US
Telephone Number : 209-475-1000
Fax Number : 209-475-1809
Authorized Official
Title or Position : COO
Name : ROBERT PACE
Credential :
Telephone Number : 213-804-1712
Provider Enumeration Date : 11/18/2005
Last Update Date : 06/11/2025

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Directions to “CALIFORNIA SPORTS PHYSICAL THERAPY CENTERS, INC. ” Practice Location

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