Provider Demographics
NPI:1891871430
Name:KINETIC HEALTH SYSTEMS
Entity Type:Organization
Organization Name:KINETIC HEALTH SYSTEMS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:A
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:415-494-5602
Mailing Address - Street 1:1 ORSI CIR
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94124-3005
Mailing Address - Country:US
Mailing Address - Phone:415-494-5602
Mailing Address - Fax:415-494-5747
Practice Address - Street 1:1 ORSI CIR
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94124-3005
Practice Address - Country:US
Practice Address - Phone:415-494-5602
Practice Address - Fax:415-494-5747
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-27
Last Update Date:2008-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT17631261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAOPT176310OtherPROVIDER ID NUMBER
CAOPT176310OtherPROVIDER ID NUMBER