| NPI | 1518686765 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNY DUONG Owner 510-299-3695 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Additional Taxonomies | 111NR0400X |
| 225100000X Physical Therapist | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2022-08-23 |
| Last Update Date | 2025-01-21 |