Healthcare Provider Details

I. General information

NPI: 1437071883
Provider Name (Legal Business Name): VINCENT LEDDY PT, DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1595 QUINTARA ST
SAN FRANCISCO CA
94116-1273
US

IV. Provider business mailing address

436 NEVADA ST
SAN FRANCISCO CA
94110-6124
US

V. Phone/Fax

Practice location:
  • Phone: 628-224-3556
  • Fax:
Mailing address:
  • Phone: 415-283-6974
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number17352
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: