Healthcare Provider Details

I. General information

NPI: 1023867082
Provider Name (Legal Business Name): LOUISE KOBIN PT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/14/2024
Last Update Date: 05/14/2024
Certification Date: 05/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17960 MOUNTAIN CHARLIE RD
LOS GATOS CA
95033-8410
US

IV. Provider business mailing address

17960 MOUNTAIN CHARLIE RD
LOS GATOS CA
95033-8410
US

V. Phone/Fax

Practice location:
  • Phone: 408-429-0757
  • Fax:
Mailing address:
  • Phone: 408-429-0757
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number22001
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: