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General NPI Number Information
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NPI Number | 1548121700
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Entity Type | Individual
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Provider Name | TYLER CHAD DUTTON
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Gender | Male
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Dates
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Enumeration Date | 11/18/2025
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Last Update Date | 11/18/2025
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Provider Practice Location Address
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Address Line | 3555 WHIPPLE RD
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City | UNION CITY
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State | CA
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Zip | 94587-1507
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Country | US
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Telephone | 510-675-4010
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Fax |
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Provider Business Mailing Address
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Address Line | 1241 LILLIAN AVE
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City | SAN LEANDRO
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State | CA
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Zip | 94578-3503
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Country | US
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Telephone | 510-928-2835
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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 | PT309107
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License Number State | CA
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