Healthcare Provider Details

I. General information

NPI: 1922878560
Provider Name (Legal Business Name): DLJPT INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/04/2024
Last Update Date: 01/04/2024
Certification Date: 01/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

681 PORTOLA DR
SAN FRANCISCO CA
94127-1207
US

IV. Provider business mailing address

681 PORTOLA DR
SAN FRANCISCO CA
94127-1207
US

V. Phone/Fax

Practice location:
  • Phone: 415-664-6492
  • Fax: 415-664-5343
Mailing address:
  • Phone: 415-664-6492
  • Fax: 415-664-5343

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: DANIEL L JAMES
Title or Position: PHYSICAL THERAPIST
Credential:
Phone: 415-664-6492