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General NPI Number Information
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NPI Number | 1245199876
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Entity Type | Organization
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Legal Business Name | CALIFORNIA REHABILITATION & SPORTS THERAPY A CALIFORNIA PHYSICAL THER
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Dates
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Enumeration Date | 01/20/2026
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Last Update Date | 01/20/2026
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Provider Practice Location Address
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Address Line | 127 HOSPITAL DR STE 101
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City | VALLEJO
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State | CA
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Zip | 94589-2500
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Country | US
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Telephone | 707-512-7290
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Fax |
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Provider Business Mailing Address
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Address Line | 2600 DALLAS PKWY STE 290
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City | FRISCO
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State | TX
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Zip | 75034-7493
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Country | US
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Telephone | 945-260-0010
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | NICHOLAS POAN
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Credential |
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Telephone | 945-260-0010
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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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