Provider Demographics
NPI:1083786230
Name:GOLDEN HILLS ORTHOPEDIC AND SPORTS PHYSICAL THERAPY INC.
Entity Type:Organization
Organization Name:GOLDEN HILLS ORTHOPEDIC AND SPORTS PHYSICAL THERAPY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SASHIKANT
Authorized Official - Middle Name:
Authorized Official - Last Name:BRAHMBHATT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-274-0888
Mailing Address - Street 1:2680 S WHITE RD STE 200
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95148-2079
Mailing Address - Country:US
Mailing Address - Phone:408-274-0888
Mailing Address - Fax:408-274-2858
Practice Address - Street 1:2680 S WHITE RD STE 200
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95148-2079
Practice Address - Country:US
Practice Address - Phone:408-274-0888
Practice Address - Fax:408-274-2858
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-14
Last Update Date:2021-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT12398225100000X
225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty