Healthcare Provider Details

I. General information

NPI: 1972249456
Provider Name (Legal Business Name): NGUYEN CARE PHYSICAL THERAPY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2022
Last Update Date: 05/09/2022
Certification Date: 05/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 LARKSPUR LANDING CIR STE 199
LARKSPUR CA
94939-1754
US

IV. Provider business mailing address

PO BOX 70661
RICHMOND CA
94807-0661
US

V. Phone/Fax

Practice location:
  • Phone: 510-913-2394
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number
License Number State

VIII. Authorized Official

Name: PAUL NGUYEN
Title or Position: OWNER
Credential: PT, DPT, OCS
Phone: 510-913-2394