Organization
HOMESTRETCH NEURO PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRIAN LLOYD BALTAZAR TRIEU-MALLARI (FOUNDER, CEO, PT)
(650) 209-0120
Entity
Organization
Contact information
Practice address
702 ACTON ST, DALY CITY, CA 94014-1374
(650) 209-0120
Mailing address
702 ACTON ST, DALY CITY, CA 94014-1374
Taxonomy
Speciality
Code
Description
License number
State
2251N0400X
Neurology Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1811557150
NPI NUMBER
CA
Enumeration date
08/23/2022
Last updated
08/23/2022
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