MEDICARE: DR. ROBERT MYLES NOAKES DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	38431	CA

General Provider Information

NPI Number	:	1003188624
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT MYLES NOAKES DPT

Provider Business Mailing Address
First Line	:	4205 SAN FELIPE RAOD
Second Line	:	SUITE 100
City	:	SAN JOSE
State	:	CA
Zip	:	95135
Country	:	US
Telephone Number	:	408-238-1552
Fax Number	:	408-238-1552

Provider Business Practice Location Address
First Line	:	4205 SAN FELIPE RD
Second Line	:	SUITE 100
City	:	SAN JOSE
State	:	CA
Zip	:	95135-1503
Country	:	US
Telephone Number	:	408-238-1552
Fax Number	:	408-238-1552

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/27/2012
Last Update Date	:	01/27/2012

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