Provider Demographics
NPI:1770655334
Name:AZCARATE, DON B (PT,AT,C)
Entity Type:Individual
Prefix:
First Name:DON
Middle Name:B
Last Name:AZCARATE
Suffix:
Gender:M
Credentials:PT,AT,C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:645 5TH ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94107-1516
Mailing Address - Country:US
Mailing Address - Phone:415-777-5009
Mailing Address - Fax:415-777-5882
Practice Address - Street 1:645 5TH ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94107-1516
Practice Address - Country:US
Practice Address - Phone:415-777-5009
Practice Address - Fax:415-777-5882
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOPT2203002251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ57908ZOtherBLUE SHIELD
CAZZZ57908ZOtherBLUE SHIELD
CAS71814Medicare UPIN