Healthcare Provider Details

I. General information

NPI: 1053686006
Provider Name (Legal Business Name): RS WELLNESS, PHYSICAL THERAPY, APC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2012
Last Update Date: 03/08/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10580 S DE ANZA BLVD
CUPERTINO CA
95014-4450
US

IV. Provider business mailing address

10580 S DE ANZA BLVD
CUPERTINO CA
95014-4450
US

V. Phone/Fax

Practice location:
  • Phone: 408-366-1735
  • Fax: 408-366-1641
Mailing address:
  • Phone: 408-366-1735
  • Fax: 408-366-1641

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number3445197
License Number StateCA

VIII. Authorized Official

Name: GARRETT AKAHOSHI
Title or Position: CEO
Credential: MPT
Phone: 408-366-1735