Organization
CONTRA COSTA PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANDRE CYRIL MALIN P.T. (OWNER)
(510) 758-1111
Entity
Organization
Contact information
Practice address
3065 RICHMOND PKWY STE 105, RICHMOND, CA 94806-5718
(510) 758-1111
Mailing address
3065 RICHMOND PKWY STE 105, RICHMOND, CA 94806-5718
(510) 758-1111
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
PT11158
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT11158
PHYSICAL THERAPY LICENSE
CA
Enumeration date
05/17/2007
Last updated
07/16/2008
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