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General NPI Number Information
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NPI Number | 1215892369
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Entity Type | Organization
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Legal Business Name | BAY LAUREL ATHLETICS PHYSICAL THERAPY, PC
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Dates
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Enumeration Date | 12/22/2025
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Last Update Date | 12/22/2025
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Provider Practice Location Address
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Address Line | 1700 INDUSTRIAL RD STE C
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City | SAN CARLOS
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State | CA
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Zip | 94070-4156
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Country | US
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Telephone | 650-733-4501
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Fax |
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Provider Business Mailing Address
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Address Line | 2530 CARLMONT DR APT 20
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City | BELMONT
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State | CA
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Zip | 94002-3248
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Country | US
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Telephone | 650-733-4501
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. LAUREL MINES
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Credential | DPT, OCS
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Telephone | 650-733-4501
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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