Provider Demographics
NPI:1598869869
Name:NAPA VALLEY PHYSICAL THERAPY CENTER
Entity Type:Organization
Organization Name:NAPA VALLEY PHYSICAL THERAPY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BOBBY
Authorized Official - Middle Name:
Authorized Official - Last Name:ISMAIL
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:209-353-1988
Mailing Address - Street 1:433 SOSCOL AVE
Mailing Address - Street 2:SUITE B 191
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94559-4036
Mailing Address - Country:US
Mailing Address - Phone:707-224-3131
Mailing Address - Fax:707-224-2356
Practice Address - Street 1:433 SOSCOL AVE
Practice Address - Street 2:SUITE B 191
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94559-4036
Practice Address - Country:US
Practice Address - Phone:707-224-3131
Practice Address - Fax:707-224-2356
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-08
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ20053ZMedicare ID - Type Unspecified