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General NPI Number Information
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NPI Number | 1730973900
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Entity Type | Organization
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Legal Business Name | FORGE PHYSICAL THERAPY PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 04/04/2025
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Last Update Date | 04/04/2025
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Provider Practice Location Address
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Address Line | 500 TAMAL PLZ STE 524
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City | CORTE MADERA
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State | CA
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Zip | 94925-1187
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Country | US
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Telephone | 646-266-7528
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Fax |
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Provider Business Mailing Address
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Address Line | 1455 FILBERT ST APT 302
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City | SAN FRANCISCO
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State | CA
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Zip | 94109-1661
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Country | US
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Telephone | 646-266-7528
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MINGXI LI
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Credential | DPT
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Telephone | 646-266-7528
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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 |
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License Number State |
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