Healthcare Provider Details
I. General information
NPI: 1205112174
Provider Name (Legal Business Name): PRENDERGAST AND RUMMER PHYS THERAPY PELVIC HEALTH & REHABILIATION CTR
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/24/2011
Last Update Date: 06/21/2024
Certification Date: 06/21/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2000 VAN NESS AVE STE 603
SAN FRANCISCO CA
94109
US
IV. Provider business mailing address
32 DANIEL WEBSTER HWY STE 16
MERRIMACK NH
03054-4860
US
V. Phone/Fax
- Phone: 415-440-7600
- Fax: 415-440-6803
- Phone: 35-899-1846
- Fax: 603-417-7135
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QP2000X |
| Taxonomy | Physical Therapy Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QP2000X |
| Taxonomy | Physical Therapy Clinic/Center |
| License Number | 27193 |
| License Number State | CA |
VIII. Authorized Official
Name:
ELIZABETH
HANDAN
AKINCILAR
Title or Position: PRESIDENT
Credential:
Phone: 415-694-2191