Provider Demographics
NPI:1285896142
Name:ESTILAEI, SUSAN KLINGAMAN (PT, DPT, OCS)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:KLINGAMAN
Last Name:ESTILAEI
Suffix:
Gender:F
Credentials:PT, DPT, OCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BOX 0625
Mailing Address - Street 2:UCSF FACULTY PRACTICE IN PHYSICAL THERAPY
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94143-0625
Mailing Address - Country:US
Mailing Address - Phone:415-476-1715
Mailing Address - Fax:415-514-9251
Practice Address - Street 1:2200 POST ST
Practice Address - Street 2:C232
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-3428
Practice Address - Country:US
Practice Address - Phone:415-476-1715
Practice Address - Fax:415-514-9251
Is Sole Proprietor?:No
Enumeration Date:2008-07-01
Last Update Date:2008-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 18202225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist