Healthcare Provider Details

I. General information

NPI: 1467156737
Provider Name (Legal Business Name): TRISTEN GIRON-FLORES PHYSICAL THERAPIST
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2023
Last Update Date: 03/29/2023
Certification Date: 03/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5767 MISSION ST
SAN FRANCISCO CA
94112-4208
US

IV. Provider business mailing address

9102 HELEN AVE
SUN VALLEY CA
91352-2043
US

V. Phone/Fax

Practice location:
  • Phone: 415-584-3294
  • Fax:
Mailing address:
  • Phone: 818-397-9468
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number303781
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: