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General NPI Number Information
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NPI Number | 1760532337
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Entity Type | Organization
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Legal Business Name | CAMPUS PHYSICAL THERAPY INC
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Dates
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Enumeration Date | 01/12/2007
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Last Update Date | 08/13/2019
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Provider Practice Location Address
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Address Line | 1800 SULLIVAN AVE RM 402
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City | DALY CITY
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State | CA
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Zip | 94015-2224
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Country | US
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Telephone | 650-994-7800
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Fax | 650-240-1834
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Provider Business Mailing Address
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Address Line | 1800 SULLIVAN AVE RM 402
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City | DALY CITY
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State | CA
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Zip | 94015-2224
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Country | US
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Telephone | 650-651-4002
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Fax | 650-240-1834
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. LUIS EDUARDO ARANEDA
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Credential | PT
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Telephone | 650-994-7800
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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 | PT15832
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License Number State | CA
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