Provider Demographics
NPI:1558460055
Name:DAVID N. BOGART, RPT
Entity Type:Organization
Organization Name:DAVID N. BOGART, RPT
Other - Org Name:SHARON HEIGHTS PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:N
Authorized Official - Last Name:BOGART
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:650-326-9080
Mailing Address - Street 1:1899 WHITE OAK DR
Mailing Address - Street 2:
Mailing Address - City:MENLO PARK
Mailing Address - State:CA
Mailing Address - Zip Code:94025-6130
Mailing Address - Country:US
Mailing Address - Phone:650-326-9080
Mailing Address - Fax:650-326-8323
Practice Address - Street 1:1899 WHITE OAK DR
Practice Address - Street 2:
Practice Address - City:MENLO PARK
Practice Address - State:CA
Practice Address - Zip Code:94025-6130
Practice Address - Country:US
Practice Address - Phone:650-326-9080
Practice Address - Fax:650-326-8323
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT9643225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ27165ZMedicare ID - Type UnspecifiedGROUP MEDICARE ID NUMBER