Provider Demographics
NPI:1760532337
Name:CAMPUS PHYSICAL THERAPY INC
Entity Type:Organization
Organization Name:CAMPUS PHYSICAL THERAPY INC
Other - Org Name:CAMPUS PHYSICAL THERAPY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:EDUARDO
Authorized Official - Last Name:ARANEDA
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:650-994-7800
Mailing Address - Street 1:1800 SULLIVAN AVE RM 402
Mailing Address - Street 2:
Mailing Address - City:DALY CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94015-2224
Mailing Address - Country:US
Mailing Address - Phone:650-651-4002
Mailing Address - Fax:650-240-1834
Practice Address - Street 1:1800 SULLIVAN AVE RM 402
Practice Address - Street 2:
Practice Address - City:DALY CITY
Practice Address - State:CA
Practice Address - Zip Code:94015-2224
Practice Address - Country:US
Practice Address - Phone:650-994-7800
Practice Address - Fax:650-240-1834
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-12
Last Update Date:2019-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT15832225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty