Provider Demographics
NPI:1164186763
Name:CS PHYSICAL THERAPY CORPORATION
Entity Type:Organization
Organization Name:CS PHYSICAL THERAPY CORPORATION
Other - Org Name:CS PHYSICAL THERAPY INC
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:MITSUTO
Authorized Official - Last Name:SHIRAISHI
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:408-246-5861
Mailing Address - Street 1:2337 FOREST AVE
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128-4606
Mailing Address - Country:US
Mailing Address - Phone:408-246-5861
Mailing Address - Fax:408-246-2066
Practice Address - Street 1:2337 FOREST AVE
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-4606
Practice Address - Country:US
Practice Address - Phone:408-246-5861
Practice Address - Fax:408-246-2066
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-29
Last Update Date:2021-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty