Biosport Physical Therapy San Joaquin Inc

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

BIOSPORT PHYSICAL THERAPY SAN JOAQUIN INC

Practice address

2156 W Grant Line Rd Ste 215
Tracy, CA 95377-7337

Phone

(209) 524-7488

Fax

(209) 522-7488

NPI assigned

Aug 15, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Leovardo Chavez, MPT, DPT, ATC

Title

Ceo/Cfo/Physical Therapist

Phone

(209) 524-7488

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1660521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664236800000",
    "number": "1679291827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 576751",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953576751",
            "telephone_number": "209-524-7488",
            "fax_number": "209-522-7488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2156 W GRANT LINE RD STE 215",
            "city": "TRACY",
            "state": "CA",
            "postal_code": "953777337",
            "telephone_number": "209-524-7488",
            "fax_number": "209-522-7488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BIOSPORT PHYSICAL THERAPY SAN JOAQUIN INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-15",
        "last_updated": "2022-09-27",
        "certification_date": "2022-09-27",
        "status": "A",
        "authorized_official_last_name": "CHAVEZ",
        "authorized_official_first_name": "LEOVARDO",
        "authorized_official_title_or_position": "CEO/CFO/PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "209-524-7488",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MPT, DPT, ATC"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sree Varsha Bhanoor, RDN
• Mehak Bhardwaj
• Ranu Bhela
• Kylene Biaggi
• Kayla Billups
• Biosport Physical Therapy Tracy Inc
• Biosport Physical Therapy Tracy LTD
• Bipinjit Kaur DDS Corp
• Birch Pain & Spine Group
• Amanique Birk

• Physical Therapist in Tracy, CA
• Providers in Tracy, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2022; 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.