Individual provider Active NPI

Austin San

  • Physical Therapist
  • Fresno, CA
National Provider Identifier
1467339036
Registry record updated Aug 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
308622 Issued in CA
Practice address
4080 N Cedar Ave
Fresno, CA 93726-5267
Phone
(559) 222-7497
NPI assigned
Aug 18, 2025
Last updated
Aug 18, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 308622 CA Primary

Addresses

Primary practice location

4080 N Cedar Ave
Fresno, CA 93726-5267

Mailing address

4080 N Cedar Ave
Fresno, CA 93726-5267
Phone (559) 222-7497

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250923003807 CA Practitioner - Physical Therapist in Private Practice 9830694611 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Barrows Training and Ed P T - Fresno a P CGroup PAC ID 8729001573, 12 clinicians
Golden Bear Physical Therapy Sports Injury Center IncGroup PAC ID 2961423082, 85 clinicians

Practice addresses (Care Compare)

1752 E Bullard Ave
Suite 103
Fresno, CA 93710-5864
Phone (559) 438-0355

4080 N Cedar Ave
Fresno, CA 93726-5267
Phone (559) 222-7497

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Physiomotion Physical Therapy, Inc. Physical Therapist CurrentSince Aug 11, 2025 Accepting new patients
Golden Bear Physical Therapy Sports Injury Center, Inc Physical Therapist CurrentSince Aug 11, 2025 Accepting new patients
Barrows Training & Ed P T - Fresno a P C Physical Therapist CurrentSince May 11, 2026 Accepting new patients

Locations

1752 E Bullard Ave
Ste 103
Fresno, CA 93710
Phone (559) 438-0355

4080 N Cedar Ave
Fresno, CA 93726
Phone (559) 222-7497

1335 Coffee Rd
Ste 200
Modesto, CA 95355
Phone (209) 576-1946

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1755475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755475200000",
    "number": "1467339036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4080 N CEDAR AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937265267",
            "telephone_number": "559-222-7497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4080 N CEDAR AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937265267",
            "telephone_number": "559-222-7497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAN",
        "first_name": "AUSTIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-08-18",
        "last_updated": "2025-08-18",
        "certification_date": "2025-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "308622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.