Provider Demographics
NPI:1467495549
Name:MURDOCK, PAUL A (PT)
Entity Type:Individual
Prefix:MR
First Name:PAUL
Middle Name:A
Last Name:MURDOCK
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1054 S DE ANZA BLVD, SUITE 120
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95129-3553
Mailing Address - Country:US
Mailing Address - Phone:408-873-8100
Mailing Address - Fax:408-873-8138
Practice Address - Street 1:1054 S DE ANZA BLVD, SUITE 120
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95129-3553
Practice Address - Country:US
Practice Address - Phone:408-873-8188
Practice Address - Fax:408-873-8138
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-14
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA244822251S0007X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports
Provider Identifiers
StateIdentifier IDID TypeIssuer
ZZZ26301ZMedicare ID - Type Unspecified