Organization
PTR SPORTS, A MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY G BLUE M.D. (PRESIDENT)
(408) 404-4700
Entity
Organization
Contact information
Practice address
1825 CIVIC CENTER DR, SUITE 25, SANTA CLARA, CA 95050-7301
(408) 404-4700
(408) 404-4701
Mailing address
1825 CIVIC CENTER DR, SUITE 25, SANTA CLARA, CA 95050-7301
(408) 404-4700
(408) 404-4701
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
—
—
Other
Enumeration date
01/29/2007
Last updated
10/28/2008
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