MEDICARE: CALIFORNIA SPORTS PHYSICAL THERAPY CENTERS, INC.

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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	183888000	OTHER	CA	DOL
2	ZZZ66185Z	OTHER	CA	BLUESHIELD
3	4435160	OTHER	CA	AETNA
4	1173851	OTHER	CA	CIGNA
5	C16964	OTHER	CA	RAILROAD

General Provider Information

NPI Number	:	1467436329
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CALIFORNIA SPORTS PHYSICAL THERAPY CENTERS, INC.

Provider Business Mailing Address
First Line	:	2600 DALLAS PKWY STE 290
Second Line	:
City	:	FRISCO
State	:	TX
Zip	:	75034-7493
Country	:	US
Telephone Number	:	945-260-0010
Fax Number	:

Provider Business Practice Location Address
First Line	:	101 WILSON RD STE C
Second Line	:
City	:	MONTEREY
State	:	CA
Zip	:	93940-7864
Country	:	US
Telephone Number	:	831-375-1885
Fax Number	:	831-375-7436

Authorized Official
Title or Position	:	OWNER
Name	:	ROBERT PACE
Credential	:
Telephone Number	:	213-804-1712

Provider Enumeration Date	:	12/05/2005
Last Update Date	:	06/06/2024

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Directions to “CALIFORNIA SPORTS PHYSICAL THERAPY CENTERS, INC. ” Practice Location

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