Provider Demographics
NPI:1962974790
Name:SU, ZIMU JIM (DPT)
Entity type:Individual
Prefix:
First Name:ZIMU
Middle Name:JIM
Last Name:SU
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:2145 THE ALAMEDA
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95126-1141
Mailing Address - Country:US
Mailing Address - Phone:408-248-6886
Mailing Address - Fax:408-556-0115
Practice Address - Street 1:987 UNIVERSITY AVE STE 18
Practice Address - Street 2:
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-7640
Practice Address - Country:US
Practice Address - Phone:408-356-2800
Practice Address - Fax:408-356-2828
Is Sole Proprietor?:No
Enumeration Date:2018-12-18
Last Update Date:2018-12-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAPT295960225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist