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General NPI Number Information
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NPI Number | 1194340232
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Entity Type | Individual
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Provider Name | DEREK TAO PT, DPT
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Gender | Male
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Dates
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Enumeration Date | 06/15/2020
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Last Update Date | 05/17/2022
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Provider Practice Location Address
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Address Line | 1085 W EL CAMINO REAL
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City | SUNNYVALE
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State | CA
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Zip | 94087-1030
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Country | US
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Telephone | 408-523-3060
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Fax |
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Provider Business Mailing Address
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Address Line | 325 DISTEL CIR
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City | LOS ALTOS
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State | CA
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Zip | 94022-1408
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 299253
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License Number State | CA
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