Provider Demographics
NPI:1598864340
Name:RED HAWK PHYSICAL THERAPY INC.
Entity Type:Organization
Organization Name:RED HAWK PHYSICAL THERAPY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:HARVEY
Authorized Official - Middle Name:M
Authorized Official - Last Name:DEUTCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-788-2100
Mailing Address - Street 1:1500 16TH ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94103-5112
Mailing Address - Country:US
Mailing Address - Phone:415-788-2100
Mailing Address - Fax:415-788-2102
Practice Address - Street 1:1500 16TH ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-5112
Practice Address - Country:US
Practice Address - Phone:415-788-2100
Practice Address - Fax:415-788-2102
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2013-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ26424ZMedicare UPIN