Pacific Coast Sports & Physical Therapy Inc.

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

PT21215 Issued in CA

Legal business name

PACIFIC COAST SPORTS & PHYSICAL THERAPY INC.

Practice address

1177 W San Carlos St
San Jose, CA 95126-3441

Phone

(714) 402-1112

Fax

(408) 993-0381

NPI assigned

Jul 9, 2006

Organization subpart

No

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

Authorized official

Name

Justin Tien Le, PT

Title

President

Phone

(714) 402-1112

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Tien Justin Le, P.T.

  • Physical Therapist
  • Orange, CA
  • NPI 1285686782
  NPD (past)

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1316970486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9362 CROSBY AVE",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928441507",
            "telephone_number": "714-402-1112",
            "fax_number": "408-993-0381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1177 W SAN CARLOS ST",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951263441",
            "telephone_number": "714-402-1112",
            "fax_number": "408-993-0381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC COAST SPORTS & PHYSICAL THERAPY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LE",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_middle_name": "TIEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-402-1112",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CA",
            "license": "PT21215",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pacific Clinics
• Pacific Clinics
• Pacific Clinics
• Pacific Clinics
• Pacific Coast Medical Clinic
• Pacific Endocrine Diabetes Health Center, Inc.
• Pacific Medical, Inc.
• Pacific Partners Medical Group Inc.
• Pacific Pharmacy
• Pacific Regenerative and Interventional Sports Medicine

• All providers in San Jose, CA
• Orthopedic Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.