Provider Demographics
NPI:1306582960
Name:PERFORMANCE PHYSICAL THERAPY
Entity type:Organization
Organization Name:PERFORMANCE PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGE
Authorized Official - Prefix:
Authorized Official - First Name:SUNDEEP
Authorized Official - Middle Name:K
Authorized Official - Last Name:SOOCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-294-3922
Mailing Address - Street 1:25 N 14TH ST STE 550
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95112-6206
Mailing Address - Country:US
Mailing Address - Phone:408-294-3922
Mailing Address - Fax:408-294-4657
Practice Address - Street 1:25 N 14TH ST STE 550
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95112-6206
Practice Address - Country:US
Practice Address - Phone:408-294-3922
Practice Address - Fax:408-294-4657
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-06
Last Update Date:2022-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty