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General NPI Number Information
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NPI Number | 1558234344
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Entity Type | Organization
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Legal Business Name | HYBRD PHYSICAL THERAPY & PERFORMANCE THEODORE KWONG
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Dates
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Enumeration Date | 09/26/2025
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Last Update Date | 10/30/2025
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Provider Practice Location Address
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Address Line | 1173 SIERRA MADRES TERR
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City | SAN JOSE
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State | CA
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Zip | 95126
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Country | US
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Telephone | 669-295-2749
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Fax |
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Provider Business Mailing Address
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Address Line | 1231 FRANKLIN MALL STE 103
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City | SANTA CLARA
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State | CA
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Zip | 95050-4806
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Country | US
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Telephone | 669-295-2749
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Fax |
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Authorized Official
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Title or Position | FOUNDER
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Name | MR. THEODORE ALDEN KWONG
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Credential | DPT
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Telephone | 669-295-2749
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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