Organization
PACIFIC COAST SPORTS & PHYSICAL THERAPY INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUSTIN TIEN LE PT (PRESIDENT)
(714) 402-1112
Entity
Organization
Contact information
Practice address
1177 W SAN CARLOS ST, SAN JOSE, CA 95126-3441
(714) 402-1112
(408) 993-0381
Mailing address
9362 CROSBY AVE, GARDEN GROVE, CA 92844-1507
(714) 402-1112
(408) 993-0381
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
PT21215
CA
Other
Enumeration date
07/09/2006
Last updated
08/22/2020
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