1598864340 NPI number — RED HAWK PHYSICAL THERAPY INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598864340 NPI number — RED HAWK PHYSICAL THERAPY INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RED HAWK PHYSICAL THERAPY INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1598864340
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/03/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1500 16TH ST
Provider Second Line Business Mailing Address:
2ND FLOOR
Provider Business Mailing Address City Name:
SAN FRANCISCO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94103-5112
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
415-788-2100
Provider Business Mailing Address Fax Number:
415-788-2102

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1500 16TH ST
Provider Second Line Business Practice Location Address:
2ND FLOOR
Provider Business Practice Location Address City Name:
SAN FRANCISCO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94103-5112
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
415-788-2100
Provider Business Practice Location Address Fax Number:
415-788-2102
Provider Enumeration Date:
09/21/2006

Additional Information

Authorized Official

Authorized Official Last Name:
DEUTCH
Authorized Official First Name:
HARVEY
Authorized Official Middle Name:
M
Authorized Official Title or Position:
LICENSED PHYSICAL THERAPIST
Authorized Official Telephone Number:
415-788-2100

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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