1487944690 NPI number — SYNAPSE PHYSICAL THERAPY INC

Table of content: (NPI 1487944690)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487944690 NPI number — SYNAPSE PHYSICAL THERAPY INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SYNAPSE 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:
1487944690
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/10/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4401 CAPITOLA RD
Provider Second Line Business Mailing Address:
SUITE 1
Provider Business Mailing Address City Name:
CAPITOLA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95010-3572
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
831-295-8231
Provider Business Mailing Address Fax Number:
831-621-4701

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4401 CAPITOLA RD
Provider Second Line Business Practice Location Address:
SUITE 1
Provider Business Practice Location Address City Name:
CAPITOLA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95010-3572
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
831-295-8231
Provider Business Practice Location Address Fax Number:
831-621-4701
Provider Enumeration Date:
04/10/2011

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
MESA
Authorized Official First Name:
ADRIANA
Authorized Official Middle Name:
Authorized Official Title or Position:
PT
Authorized Official Telephone Number:
831-713-7457

Provider Taxonomy Codes

  • Taxonomy code: 225100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 2251N0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2251P0200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2251X0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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