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General NPI Number Information
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NPI Number | 1477362846
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Entity Type | Individual
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Provider Name | STEPHANE PAUL ROBERT PT, DPT
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Gender | Male
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Dates
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Enumeration Date | 12/31/2024
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Last Update Date | 12/31/2024
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Provider Practice Location Address
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Address Line | 1700 CALIFORNIA ST STE 530
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City | SAN FRANCISCO
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State | CA
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Zip | 94109-4591
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Country | US
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Telephone | 415-921-1758
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Fax |
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Provider Business Mailing Address
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Address Line | 7944 139TH AVE SE
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City | NEWCASTLE
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State | WA
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Zip | 98059-3228
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Country | US
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Telephone | 425-577-2316
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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 | 306373
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License Number State | CA
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