MEDICARE: PAUL A NORQUIST PT

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	PT25917	CA

General Provider Information

NPI Number	:	1740297647
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAUL A NORQUIST PT

Provider Business Mailing Address
First Line	:	1530 MERIDIAN AVE
Second Line	:	SUITE 150
City	:	SAN JOSE
State	:	CA
Zip	:	95125-5350
Country	:	US
Telephone Number	:	408-979-2300
Fax Number	:	408-979-2301

Provider Business Practice Location Address
First Line	:	1530 MERIDIAN AVE
Second Line	:	SUITE 150
City	:	SAN JOSE
State	:	CA
Zip	:	95125-5350
Country	:	US
Telephone Number	:	408-979-2300
Fax Number	:	408-979-2301

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

Provider Enumeration Date	:	08/02/2006
Last Update Date	:	03/05/2008

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