Healthcare Provider Details

I. General information

NPI: 1134597453
Provider Name (Legal Business Name): PACIFIC RIM PHYSICAL THERAPY P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/03/2015
Last Update Date: 09/03/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 N 13TH ST SUITE A
SAN JOSE CA
95112-3528
US

IV. Provider business mailing address

PO BOX 4626
MOUNTAIN VIEW CA
94040-0626
US

V. Phone/Fax

Practice location:
  • Phone: 408-436-5522
  • Fax: 408-436-8777
Mailing address:
  • Phone: 408-436-5522
  • Fax: 408-436-8777

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License NumberPT22207
License Number StateCA

VIII. Authorized Official

Name: DR. JINJIAN CHEN
Title or Position: OWNER
Credential:
Phone: 408-436-5522