Healthcare Provider Details

I. General information

NPI: 1245026194
Provider Name (Legal Business Name): OHANESSIAN PHYSICAL THERAPY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2025
Last Update Date: 04/17/2025
Certification Date: 04/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

166 SPRINGFIELD DR
SAN FRANCISCO CA
94132-1455
US

IV. Provider business mailing address

166 SPRINGFIELD DR
SAN FRANCISCO CA
94132-1455
US

V. Phone/Fax

Practice location:
  • Phone: 415-420-7623
  • Fax:
Mailing address:
  • Phone: 415-420-7623
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: GREG OHANESSIAN
Title or Position: PRESIDENT
Credential: PT
Phone: 415-420-7623