Provider Demographics
NPI:1245357227
Name:PINNACLE PHYSICAL THERAPY, INC.
Entity type:Organization
Organization Name:PINNACLE PHYSICAL THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:NIRAJ
Authorized Official - Middle Name:D
Authorized Official - Last Name:HAZARI
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:650-967-5100
Mailing Address - Street 1:2483 OLD MIDDLEFIELD WAY STE 180
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94043-2359
Mailing Address - Country:US
Mailing Address - Phone:650-967-5100
Mailing Address - Fax:650-967-5101
Practice Address - Street 1:2483 OLD MIDDLEFIELD WAY STE 180
Practice Address - Street 2:
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94043-2359
Practice Address - Country:US
Practice Address - Phone:650-967-5100
Practice Address - Fax:650-967-5101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-23
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSportsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ23938ZMedicare ID - Type UnspecifiedMEDICARE NUMBER