Mission District Physical Therapy & Rehabilitation

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

PT16150 Issued in CA

Legal business name

MISSION DISTRICT PHYSICAL THERAPY & REHABILITATION

Practice address

3490 20TH St FL 1
San Francisco, CA 94110-2582

Phone

(415) 824-4228

Fax

(415) 824-4678

NPI assigned

Mar 30, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Raul Hugo Caimanque, PTNPI 1841322963

Title

Owner & Director

Phone

(415) 824-4228

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Mission District Physical Therapy Rehabilitation2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Mission District Physical Therapy & Rehabilitation Inc

  • Physical Therapist
  • Daly City, CA
  • NPI 1285858282
  NPD tax ID

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Raul H Caimanque, PT

  • Physical Therapist
  • San Francisco, CA
  • NPI 1841322963
  NPD (past) Authorized official
• Jill Elizabeth Gleason, PT

  • Physical Therapist
  • San Francisco, CA
  • NPI 1124150230
  NPD (past)
• Elizabeth McDonald, PT

  • Physical Therapist
  • San Francisco, CA
  • NPI 1407327745
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1490832000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490832000000",
    "number": "1174055073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3490 20TH ST FL 1",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941102582",
            "telephone_number": "415-824-4228",
            "fax_number": "415-824-4678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3490 20TH ST FL 1",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941102582",
            "telephone_number": "415-824-4228",
            "fax_number": "415-824-4678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSION DISTRICT PHYSICAL THERAPY & REHABILITATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-30",
        "last_updated": "2017-03-30",
        "status": "A",
        "authorized_official_last_name": "CAIMANQUE",
        "authorized_official_first_name": "RAUL",
        "authorized_official_middle_name": "HUGO",
        "authorized_official_title_or_position": "OWNER & DIRECTOR",
        "authorized_official_telephone_number": "415-824-4228",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "CA",
            "license": "PT16150",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA DRIVERS LICENSE",
            "identifier": "B9323545",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mission Bay Dental
• Mission Council
• Mission Council Family Day Treatment and Aftercare Program
• Mission Council on Alcohol Abuse for the Spanish Speaking
• Mission Council. Inc.
• Mission District Physical Therapy & Rehabilitation, Inc
• Mission Family Center
• Mission Family Therapy, Inc.
• Mission Gastroenterology and Hepatology Inc
• Mission Mental Health Clinic

• Physical Therapy Clinic/Center in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Physical Therapy Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.