Provider Demographics
NPI:1053686006
Name:RS WELLNESS, PHYSICAL THERAPY, APC
Entity Type:Organization
Organization Name:RS WELLNESS, PHYSICAL THERAPY, APC
Other - Org Name:PEAK PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:GARRETT
Authorized Official - Middle Name:
Authorized Official - Last Name:AKAHOSHI
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:408-366-1735
Mailing Address - Street 1:10580 S DE ANZA BLVD
Mailing Address - Street 2:
Mailing Address - City:CUPERTINO
Mailing Address - State:CA
Mailing Address - Zip Code:95014-4450
Mailing Address - Country:US
Mailing Address - Phone:408-366-1735
Mailing Address - Fax:408-366-1641
Practice Address - Street 1:10580 S DE ANZA BLVD
Practice Address - Street 2:
Practice Address - City:CUPERTINO
Practice Address - State:CA
Practice Address - Zip Code:95014-4450
Practice Address - Country:US
Practice Address - Phone:408-366-1735
Practice Address - Fax:408-366-1641
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-08
Last Update Date:2012-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA3445197261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy