Provider Demographics
NPI:1518020593
Name:JOHN SORIANO RPT PA
Entity Type:Organization
Organization Name:JOHN SORIANO RPT PA
Other - Org Name:ORTHOPEDIC PHYSICAL THERAPY AND WELLNESS INC
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:G
Authorized Official - Last Name:SORIANO
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:415-480-8011
Mailing Address - Street 1:20 SYCAMORE ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-1222
Mailing Address - Country:US
Mailing Address - Phone:415-480-8011
Mailing Address - Fax:415-255-8211
Practice Address - Street 1:333 VALENCIA ST
Practice Address - Street 2:SUITE #100
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-3547
Practice Address - Country:US
Practice Address - Phone:415-480-8011
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-19
Last Update Date:2014-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA26708225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHL190AMedicare PIN