Provider Demographics
NPI:1336788629
Name:CAMPUS ORTHOPEDICS PHYSICAL THERAPY, INC.
Entity Type:Organization
Organization Name:CAMPUS ORTHOPEDICS PHYSICAL THERAPY, INC.
Other - Org Name:SAN MATEO PHYSICAL THERAPY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:
Authorized Official - Last Name:ARANEDA
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
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:650-994-7800
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:2020-01-03
Last Update Date:2020-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy