Individual
NAM DO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
1103 S PARK VICTORIA DR, MILPITAS, CA 95035-6942
(408) 263-2020
(408) 263-8537
Mailing address
1103 S PARK VICTORIA DR, MILPITAS, CA 95035-6942
(408) 263-2020
(408) 263-8537
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
PT 38401
CA
Other
Enumeration date
02/02/2012
Last updated
01/03/2022
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