# PACIFIC THERAPY AND REHAB, INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1962568493
- **Authorized official:** ROBERT CHAN (VICE PRESIDENT)
- **Authorized official phone:** (408) 832-9656

## Contact information

- **Practice address:** 39159 PASEO PADRE PKWY, SUITE 111, FREMONT, CA 94538-1608
- **Practice address phone:** (510) 505-9800
- **Practice address fax:** (510) 505-9880
- **Mailing address:** PO BOX 610638, SAN JOSE, CA 95161-0638
- **Mailing address phone:** (408) 832-9656
- **Mailing address fax:** (510) 505-9880

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR0400X | Rehabilitation Clinic/Center | OT5979 | CA | Yes |

## Other

- **Enumeration date:** 12/29/2006
- **Last updated:** 07/31/2008