Healthcare Provider Details

I. General information

NPI: 1649032319
Provider Name (Legal Business Name): JBMPT, A PROFESSIONAL PHYSICAL THERAPY CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2024
Last Update Date: 01/26/2024
Certification Date: 01/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

732 DELANO AVE
SAN FRANCISCO CA
94112-3322
US

IV. Provider business mailing address

732 DELANO AVE
SAN FRANCISCO CA
94112-3322
US

V. Phone/Fax

Practice location:
  • Phone: 415-409-8708
  • Fax:
Mailing address:
  • Phone: 415-409-8708
  • 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: DR. JOSEPH BRADLEY MATEO
Title or Position: OWNER/PHYSICAL THERAPIST
Credential: PT, DPT
Phone: 415-409-8708