Provider Demographics
NPI:1700947116
Name:HORVITZ, GARY (PT)
Entity Type:Individual
Prefix:MR
First Name:GARY
Middle Name:
Last Name:HORVITZ
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:KAISER PERMANENTE
Mailing Address - Street 2:901 NEVIN AVE.
Mailing Address - City:RICHMOND
Mailing Address - State:CA
Mailing Address - Zip Code:94801-5947
Mailing Address - Country:US
Mailing Address - Phone:510-307-2571
Mailing Address - Fax:510-307-2565
Practice Address - Street 1:901 NEVIN AVE.
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:CA
Practice Address - Zip Code:94801-5947
Practice Address - Country:US
Practice Address - Phone:510-307-2571
Practice Address - Fax:510-307-2565
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 12982225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPT12982OtherSTATE LICENSE #