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General NPI Number Information
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NPI Number | 1154558559
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Entity Type | Organization
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Legal Business Name | SUN PHYSICAL THERAPY
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Dates
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Enumeration Date | 06/12/2009
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Last Update Date | 06/12/2009
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Provider Practice Location Address
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Address Line | 3800 WALNUT AVE APT 303B SUN PHYSICAL THERAPY
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City | FREMONT
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State | CA
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Zip | 94538-2290
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Country | US
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Telephone | 510-742-9580
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Fax |
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Provider Business Mailing Address
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Address Line | 3800 WALNUT AVE APT 303B SUN PHYSICAL THERAPY
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City | FREMONT
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State | CA
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Zip | 94538-2290
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Country | US
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Telephone | 510-742-9580
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Fax |
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | URVASHI PATEL
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Credential | M.A., P.T.
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Telephone | 510-742-9580
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT21357
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License Number State | CA
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