Provider Demographics
NPI:1043773385
Name:BERKELEY COMMUNITY PHYSICAL THERAPY INC
Entity Type:Organization
Organization Name:BERKELEY COMMUNITY PHYSICAL THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:NEGEENE
Authorized Official - Middle Name:
Authorized Official - Last Name:MOSAED
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:510-549-2225
Mailing Address - Street 1:2041 BANCROFT WAY STE 301
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94704-1443
Mailing Address - Country:US
Mailing Address - Phone:510-549-2225
Mailing Address - Fax:510-549-0741
Practice Address - Street 1:2041 BANCROFT WAY STE 301
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94704-1443
Practice Address - Country:US
Practice Address - Phone:510-549-2225
Practice Address - Fax:510-549-0741
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-12
Last Update Date:2019-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty