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General NPI Number Information
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NPI Number | 1932865243
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Entity Type | Organization
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Legal Business Name | HALF MOON BAY PHYSICAL THERAPY CORP.
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Dates
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Enumeration Date | 11/10/2021
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Last Update Date | 09/02/2025
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Provider Practice Location Address
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Address Line | 225 CABRILLO HWY S # 106D
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City | HALF MOON BAY
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State | CA
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Zip | 94019-8200
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Country | US
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Telephone | 650-440-4717
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Fax | 650-440-4736
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Provider Business Mailing Address
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Address Line | 225 CABRILLO HWY S # 106D
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City | HALF MOON BAY
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State | CA
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Zip | 94019-8200
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Country | US
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Telephone | 650-440-4717
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Fax | 650-440-4736
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Authorized Official
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Title or Position | PRESIDENT
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Name | REYNA LUBACH
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Credential | DPT
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Telephone | 650-440-4717
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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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Taxonomy #2
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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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