Healthcare Provider Details

I. General information

NPI: 1881676377
Provider Name (Legal Business Name): RICHARD P CARR PHYSICAL THERAPY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/18/2005
Last Update Date: 06/11/2025
Certification Date: 06/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3097 MOORPARK AVE STE 100
SAN JOSE CA
95128-2543
US

IV. Provider business mailing address

2035 CORTE DEL NOGAL STE 200
CARLSBAD CA
92011-1445
US

V. Phone/Fax

Practice location:
  • Phone: 669-247-6170
  • Fax: 669-253-2092
Mailing address:
  • Phone: 945-260-0010
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: ROBERT PACE
Title or Position: OWNER, COO
Credential:
Phone: 760-268-7500