Provider Demographics
NPI:1861654790
Name:ALMADEN PHYSICAL THERAPY
Entity Type:Organization
Organization Name:ALMADEN PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR P.T.
Authorized Official - Prefix:MS
Authorized Official - First Name:SUPRIYA
Authorized Official - Middle Name:
Authorized Official - Last Name:MANIAR
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:408-268-0600
Mailing Address - Street 1:6489 CAMDEN AVE
Mailing Address - Street 2:SUITE 109
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95120-2849
Mailing Address - Country:US
Mailing Address - Phone:408-268-0600
Mailing Address - Fax:408-268-0602
Practice Address - Street 1:6489 CAMDEN AVE
Practice Address - Street 2:SUITE 109
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95120-2849
Practice Address - Country:US
Practice Address - Phone:408-268-0600
Practice Address - Fax:408-268-0602
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-01
Last Update Date:2008-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0PT157630Medicare PIN