Physiosport: Performance and Physical Therapy Inc.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

PHYSIOSPORT: PERFORMANCE AND PHYSICAL THERAPY INC.

Practice address

4929 Franco Ave
Stockton, CA 95212-1909

Phone

(209) 481-7336

NPI assigned

Dec 27, 2020

Organization subpart

No

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

Authorized official

Name

Mahmoud Daher, DPTNPI 1316289390

Title

Ceo/President

Phone

(209) 481-7336

Specialties & licenses 1

Addresses

Practitioners 1

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

• Mahmoud H Daher, D.P.T

  • Physical Therapist
  • Stockton, CA
  • NPI 1316289390
  NPD Authorized official

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

{
    "created_epoch": "1609027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609113600000",
    "number": "1265029128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4929 FRANCO AVE",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952121909",
            "telephone_number": "209-481-7336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4929 FRANCO AVE",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952121909",
            "telephone_number": "209-481-7336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSIOSPORT: PERFORMANCE AND PHYSICAL THERAPY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-27",
        "last_updated": "2020-12-28",
        "certification_date": "2020-12-28",
        "status": "A",
        "authorized_official_last_name": "DAHER",
        "authorized_official_first_name": "MAHMOUD",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "209-481-7336",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Vang Phoong
• Megan Phornsavanh
• Sidaphone Anna Phovixay, ASW61745
• Amarpreet K Phul
• Jennifer Thuy Ho Phung, M.D.
• Torrie Alyn-Hughes Piasecki, LCSW
• Francesca Piazza
• Mirella Elizabeth Piceno
• Yomira Pichardo
• Adriana Picos

• Durable Medical Equipment & Medical Supplies in Stockton, CA
• Providers in Stockton, CA by specialty
• Durable Medical Equipment & Medical Supplies in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2020; 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.