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General NPI Number Information
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NPI Number | 1922829480
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Entity Type | Organization
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Legal Business Name | THE HEALTHY PELVIS
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Dates
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Enumeration Date | 10/17/2024
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Last Update Date | 05/21/2025
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Provider Practice Location Address
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Address Line | 900 N SAN ANTONIO RD STE 101
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City | LOS ALTOS
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State | CA
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Zip | 94022-1338
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Country | US
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Telephone | 415-779-2396
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Fax |
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Provider Business Mailing Address
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Address Line | 900 N SAN ANTONIO RD STE 101
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City | LOS ALTOS
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State | CA
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Zip | 94022-1338
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF OPERAIONS
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Name | DIANA FONG
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Credential |
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Telephone | 415-779-2396
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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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