Provider Demographics
NPI:1427067073
Name:RISING SUN PHYSICAL THERAPY
Entity type:Organization
Organization Name:RISING SUN PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST, OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:BETTINA
Authorized Official - Middle Name:KIRA
Authorized Official - Last Name:NEUMANN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:415-282-4083
Mailing Address - Street 1:500 SUTTER ST STE 512
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94102-1114
Mailing Address - Country:US
Mailing Address - Phone:415-282-4083
Mailing Address - Fax:415-362-4084
Practice Address - Street 1:500 SUTTER STREET STE 512
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102-1114
Practice Address - Country:US
Practice Address - Phone:415-282-4083
Practice Address - Fax:415-362-4084
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-05
Last Update Date:2007-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 18458225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0PT184580Medicare PIN