Provider Demographics
NPI:1407337389
Name:CHRISTY, ROBERT DARE (PT, DPT)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:DARE
Last Name:CHRISTY
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 VETERANS BLVD STE 230
Mailing Address - Street 2:
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94063-1740
Mailing Address - Country:US
Mailing Address - Phone:650-701-0390
Mailing Address - Fax:650-701-0105
Practice Address - Street 1:900 VETERANS BLVD STE 230
Practice Address - Street 2:
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94063-1740
Practice Address - Country:US
Practice Address - Phone:650-701-0390
Practice Address - Fax:650-701-0105
Is Sole Proprietor?:No
Enumeration Date:2018-08-28
Last Update Date:2020-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT013504225100000X
CAPT299234225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist