Healthcare Provider Details

I. General information

NPI: 1295132736
Provider Name (Legal Business Name): ATLAS PHYSICAL THERAPY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/27/2014
Last Update Date: 02/03/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21115 FREEDOM DR
CUPERTINO CA
95014-5705
US

IV. Provider business mailing address

21115 FREEDOM DR
CUPERTINO CA
95014-5705
US

V. Phone/Fax

Practice location:
  • Phone: 408-505-8504
  • Fax:
Mailing address:
  • Phone: 408-505-8504
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number40282
License Number StateCA

VIII. Authorized Official

Name: CLAIRE UNABIA
Title or Position: DIRECTOR
Credential: PHYSICAL THERAPIST
Phone: 408-505-8504