Healthcare Provider Details

I. General information

NPI: 1477631653
Provider Name (Legal Business Name): JOSEPH E RIZZA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2006
Last Update Date: 06/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3401 EL CAMINO REAL
PALO ALTO CA
94306-2805
US

IV. Provider business mailing address

3401 EL CAMINO REAL
PALO ALTO CA
94306-2805
US

V. Phone/Fax

Practice location:
  • Phone: 650-852-1228
  • Fax: 650-852-0102
Mailing address:
  • Phone: 650-852-1228
  • Fax: 650-852-0102

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License NumberPT10504
License Number StateCA

VIII. Authorized Official

Name: JOSEPH E RIZZA
Title or Position: DIRECTOR
Credential: PT
Phone: 650-852-1228