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General NPI Number Information
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NPI Number | 1649714866
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Entity Type | Organization
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Legal Business Name | ACTS PHYSICAL THERAPY INC.
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Dates
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Enumeration Date | 12/07/2016
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Last Update Date | 12/07/2016
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Provider Practice Location Address
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Address Line | 1800 SULLIVAN AVE SUITE 504
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City | DALY CITY
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State | CA
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Zip | 94015-2228
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Country | US
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Telephone | 415-812-2826
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Fax |
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Provider Business Mailing Address
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Address Line | 20 HUCKLEBERRY CT
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City | BRISBANE
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State | CA
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Zip | 94005-1264
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Country | US
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Telephone | 626-383-7006
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. VIOLA FAN
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Credential | PT, DPT, MS
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Telephone | 626-383-7006
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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 | CA34394
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License Number State | CA
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