Provider Demographics
NPI:1215005921
Name:SAN RAMON VALLEY PHYSICAL THERAPY INC.
Entity Type:Organization
Organization Name:SAN RAMON VALLEY PHYSICAL THERAPY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DOMINICK
Authorized Official - Middle Name:
Authorized Official - Last Name:GABOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:925-552-5787
Mailing Address - Street 1:917 SAN RAMON VALLEY BLVD STE 190
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94526-4032
Mailing Address - Country:US
Mailing Address - Phone:925-552-5787
Mailing Address - Fax:925-552-6173
Practice Address - Street 1:917 SAN RAMON VALLEY BLVD STE 190
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:CA
Practice Address - Zip Code:94526-4032
Practice Address - Country:US
Practice Address - Phone:925-552-5787
Practice Address - Fax:925-552-6173
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-01
Last Update Date:2021-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA237332251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty