Healthcare Provider Details

I. General information

NPI: 1083989545
Provider Name (Legal Business Name): INFOCUS PHYSICAL THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2012
Last Update Date: 03/16/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2504 SAMARITAN DR STE 20A
SAN JOSE CA
95124-4005
US

IV. Provider business mailing address

240 OAKHURST WAY
MILPITAS CA
95035-4469
US

V. Phone/Fax

Practice location:
  • Phone: 510-790-0383
  • Fax: 510-790-1197
Mailing address:
  • Phone: 215-833-4990
  • Fax: 510-790-1197

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: RUPALI BHAVIN VYAS
Title or Position: PHYSICAL THERAPIST
Credential:
Phone: 215-833-4990