Healthcare Provider Details

I. General information

NPI: 1851007629
Provider Name (Legal Business Name): CALIFORNIA SPORTS PHYSICAL THERAPY CENTERS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2023
Last Update Date: 06/06/2024
Certification Date: 06/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2792 NAGLEE RD
TRACY CA
95304-7309
US

IV. Provider business mailing address

2600 DALLAS PKWY STE 290
FRISCO TX
75034-7493
US

V. Phone/Fax

Practice location:
  • Phone: 209-433-6510
  • Fax: 209-284-2361
Mailing address:
  • Phone: 945-260-0010
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
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: COO
Credential:
Phone: 213-804-1712