Healthcare Provider Details

I. General information

NPI: 1275981730
Provider Name (Legal Business Name): GARRETT D CESCA DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/25/2016
Last Update Date: 05/25/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 EMBARCADERO CTR LOBBY LEVEL
SAN FRANCISCO CA
94111-4003
US

IV. Provider business mailing address

PO BOX 1848
NOVATO CA
94948-1848
US

V. Phone/Fax

Practice location:
  • Phone: 415-495-2225
  • Fax: 415-495-2228
Mailing address:
  • Phone: 415-892-7560
  • Fax: 415-892-7509

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number41150
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: