Peter J Fabian, P.T.

Individual provider Active NPI Physical Therapist · Larkspur, CA

NPI 1275852196 · NPPES record last updated May 18, 2010

Key facts

NPI
1275852196
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
PT12005 (CA)
Practice address
5 Bon Air Rd
C-116
Larkspur, CA 94939-1143
Phone
(415) 261-7379
NPI assigned
May 18, 2010
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
PT12005CAMDPhysical Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT12005 CA Yes

Addresses

Primary practice location

5 Bon Air Rd
C-116
Larkspur, CA 94939-1143

Mailing address

5 Bon Air Rd
C-116
Larkspur, CA 94939-1143
Phone (415) 261-7379

Other providers in Larkspur, CA

All providers in Larkspur, CA · Physical Therapist in California

Sources for this page

Verify at the official NPI Registry.