Provider Demographics
NPI:1598877870
Name:ACTION SPORTS MEDICINE
Entity Type:Organization
Organization Name:ACTION SPORTS MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:A
Authorized Official - Last Name:SORIANO
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:415-307-0595
Mailing Address - Street 1:3640 26TH ST
Mailing Address - Street 2:5
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-4383
Mailing Address - Country:US
Mailing Address - Phone:415-307-0595
Mailing Address - Fax:866-826-1821
Practice Address - Street 1:290 DIVISION ST
Practice Address - Street 2:200
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-4882
Practice Address - Country:US
Practice Address - Phone:415-863-4922
Practice Address - Fax:866-826-1821
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT244652251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty