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General NPI Number Information
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NPI Number | 1437224383
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Entity Type | Organization
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Legal Business Name | EAST BAY PHYSICAL THERAPY, INC.
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Dates
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Enumeration Date | 11/22/2006
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Last Update Date | 04/17/2019
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Provider Practice Location Address
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Address Line | 3571 SAN PABLO DAM RD
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City | RICHMOND
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State | CA
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Zip | 94803-2727
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Country | US
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Telephone | 510-222-8080
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Fax | 510-222-8083
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Provider Business Mailing Address
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Address Line | 3571 SAN PABLO DAM RD
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City | RICHMOND
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State | CA
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Zip | 94803-2727
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Country | US
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Telephone | 510-222-8080
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Fax | 510-222-8083
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. MATTHEW MICHAEL SCERRI
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Credential | B.S.
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Telephone | 510-222-8080
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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 | 22298
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 19723
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License Number State | CA
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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 | 12835
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License Number State | CA
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