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General NPI Number Information
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NPI Number | 1043773385
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Entity Type | Organization
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Legal Business Name | BERKELEY COMMUNITY PHYSICAL THERAPY INC
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Dates
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Enumeration Date | 04/12/2019
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Last Update Date | 08/28/2024
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Provider Practice Location Address
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Address Line | 1834 UNIVERSITY AVE
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City | BERKELEY
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State | CA
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Zip | 94703-1516
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Country | US
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Telephone | 510-549-2225
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Fax | 510-549-0741
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Provider Business Mailing Address
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Address Line | 1834 UNIVERSITY AVE
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City | BERKELEY
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State | CA
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Zip | 94703-1516
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Country | US
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Telephone | 510-549-2225
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Fax | 510-549-0741
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Authorized Official
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Title or Position | PROPRIETOR
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Name | NEGEENE MOSAED
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Credential | PT
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Telephone | 510-549-2225
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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