Healthcare Provider Details

I. General information

NPI: 1184413619
Provider Name (Legal Business Name): COREDYNAMICS PHYSICAL THERAPY AND ERGONOMICS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2025
Last Update Date: 05/01/2025
Certification Date: 04/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6756 HICKORY LN
DUBLIN CA
94568-2605
US

IV. Provider business mailing address

6756 HICKORY LN
DUBLIN CA
94568-2605
US

V. Phone/Fax

Practice location:
  • Phone: 660-238-2174
  • Fax:
Mailing address:
  • Phone: 660-238-2174
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name: HIMANI PATEL
Title or Position: CEO
Credential:
Phone: 660-238-2174