Provider Demographics
NPI:1578642567
Name:STERLING PHYSICAL THERAPY PC
Entity Type:Organization
Organization Name:STERLING PHYSICAL THERAPY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:RAMACHANDRA
Authorized Official - Middle Name:RAJU
Authorized Official - Last Name:MANTENA
Authorized Official - Suffix:
Authorized Official - Credentials:RPT
Authorized Official - Phone:408-763-8099
Mailing Address - Street 1:2324 MONTPELIER DR
Mailing Address - Street 2:SUITE 1
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95116-1612
Mailing Address - Country:US
Mailing Address - Phone:408-763-8099
Mailing Address - Fax:408-724-6599
Practice Address - Street 1:2324 MONTPELIER DR
Practice Address - Street 2:SUITE 1
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95116-1612
Practice Address - Country:US
Practice Address - Phone:408-763-8099
Practice Address - Fax:408-724-6599
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-02
Last Update Date:2021-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA39439225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty