Healthcare Provider Details

I. General information

NPI: 1659233294
Provider Name (Legal Business Name): TOMOHIRO HAYASHI
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/02/2025
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2160 APPIAN WAY STE 101
PINOLE CA
94564-2524
US

IV. Provider business mailing address

55 DIAS CT
EL SOBRANTE CA
94803-2607
US

V. Phone/Fax

Practice location:
  • Phone: 510-724-1248
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number054699
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: