Healthcare Provider Details
I. General information
NPI: 1891472965
Provider Name (Legal Business Name): CALIFORNIA SPORTS PHYSICAL THERAPY CENTERS INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/30/2023
Last Update Date: 06/06/2024
Certification Date: 06/06/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
948 SAN PABLO AVE
ALBANY CA
94706-2010
US
IV. Provider business mailing address
2600 DALLAS PKWY STE 290
FRISCO TX
75034-7493
US
V. Phone/Fax
- Phone: 510-526-2353
- Fax: 510-526-2022
- Phone: 945-260-0010
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ROBERT
PACE
Title or Position: COO
Credential:
Phone: 213-804-1712