Provider Demographics
NPI:1396044194
Name:G SPORTS PHYSICAL THERAPY, INC.
Entity type:Organization
Organization Name:G SPORTS PHYSICAL THERAPY, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/PHYSICAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:GEE
Authorized Official - Suffix:
Authorized Official - Credentials:DPT, CMP
Authorized Official - Phone:415-732-5608
Mailing Address - Street 1:332 PINE ST
Mailing Address - Street 2:SUITE 610
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94104-3206
Mailing Address - Country:US
Mailing Address - Phone:415-732-5608
Mailing Address - Fax:415-732-0345
Practice Address - Street 1:332 PINE ST
Practice Address - Street 2:SUITE 610
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94104-3206
Practice Address - Country:US
Practice Address - Phone:415-732-5608
Practice Address - Fax:415-732-0345
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-18
Last Update Date:2012-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAFE641AOtherMEDICARE PTAN