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General NPI Number Information
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NPI Number | 1396060687
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Entity Type | Organization
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Legal Business Name | PACIFIC ORTHOPAEDIC & SPORTS REHABILITATION
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Dates
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Enumeration Date | 03/30/2010
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Last Update Date | 03/30/2010
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Provider Practice Location Address
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Address Line | 5915 HOLLIS ST STE A
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City | EMERYVILLE
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State | CA
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Zip | 94608-2066
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Country | US
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Telephone | 510-923-0700
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Fax |
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Provider Business Mailing Address
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Address Line | 5915 HOLLIS ST STE A
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City | EMERYVILLE
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State | CA
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Zip | 94608-2066
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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 | DIRECTOR
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Name | MR. NATHAN SANCHEZ
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Credential |
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Telephone | 925-803-0224
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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