Golden Bear Physical Therapy Sports Injury Center, Inc

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

GOLDEN BEAR PHYSICAL THERAPY SPORTS INJURY CENTER, INC

Practice address

4318 Spyres Way
Modesto, CA 95356-9259

Phone

(209) 576-0710

Fax

(209) 622-4159

NPI assigned

Oct 5, 2006

Last updated

Dec 6, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Bobby Ismail, DPTNPI 1295880656

Title

Ceo

Phone

(209) 353-1988

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Tax ID family

Golden Bear Physical2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Golden Bear Physical Therapy

  • Physical Therapy Assistant
  • Modesto, CA
  • NPI 1841669710
  NPD tax ID

Locations (25 of 29)

Practitioners 191

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Sabrina Nisha Ali Khan

  • Physical Therapist
  • Modesto, CA
  • NPI 1508630666
  Medicare reassignment Care Compare group NPD
• Michelle Arroyo, PT, DPT

  • Physical Therapist
  • Livingston, CA
  • NPI 1609559145
  Medicare reassignment Care Compare group NPD
• Jon Ryan Aycock, PT

  • Physical Therapist
  • Modesto, CA
  • NPI 1699006833
  Medicare reassignment Care Compare group NPD
• Adorina Babazadeh

  • Physical Therapist
  • Livingston, CA
  • NPI 1205796364
  Medicare reassignment Care Compare group NPD
• Dominic Baiocco, DPT

  • Physical Therapist
  • San Jose, CA
  • NPI 1285152736
  Medicare reassignment Care Compare group NPD
• Daniel Banuelos Jr., DPT

  • Physical Therapist
  • Salinas, CA
  • NPI 1336963503
  Medicare reassignment Care Compare group NPD
• Jordan Michael Barnett

  • Physical Therapist
  • Turlock, CA
  • NPI 1053135798
  Medicare reassignment Care Compare group NPD
• Jennifer Barrueta

  • Physical Therapist
  • Salinas, CA
  • NPI 1750257234
  Medicare reassignment Care Compare group NPD
• Kevin Patrick Bergman, DPT

  • Physical Therapist
  • Manteca, CA
  • NPI 1184009771
  Medicare reassignment Care Compare group NPD
• Joshua Michael Bongiovanni, PT

  • Physical Therapist
  • Tracy, CA
  • NPI 1588322721
  Medicare reassignment Care Compare group NPD
• Esmeralda Campos, DPT

  • Physical Therapist
  • Modesto, CA
  • NPI 1154214153
  Medicare reassignment Care Compare group NPD
• Wesley Chan, PT

  • Physical Therapist
  • Marina, CA
  • NPI 1619667946
  Medicare reassignment Care Compare group NPD

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

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    "enumeration_type": "NPI-2",
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    "number": "1811084676",
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            "address_1": "PO BOX 52219",
            "city": "PHOENIX",
            "state": "AZ",
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            "telephone_number": "209-576-0888",
            "fax_number": "209-576-0913"
        },
        {
            "country_code": "US",
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            "state": "CA",
            "postal_code": "953569259",
            "telephone_number": "209-576-0710",
            "fax_number": "209-622-4159"
        }
    ],
    "practiceLocations": [
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            "address_1": "1229 Commerce Ave",
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            "postal_code": "953015224",
            "country_code": "US",
            "telephone_number": "209-683-1386",
            "fax_number": "209-222-6185",
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        {
            "address_1": "1335 Coffee Rd Ste 200",
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        {
            "address_1": "2908 E Whitmore Ave Ste E",
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            "address_1": "2222 Francisco Dr",
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        {
            "address_1": "4080 N Cedar Ave",
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            "country_code": "US",
            "telephone_number": "559-222-7497",
            "fax_number": "559-224-9310",
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            "address_1": "468 Winton Pkwy",
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            "country_code": "US",
            "telephone_number": "209-398-8740",
            "fax_number": "209-222-6185",
            "country_name": "United States",
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        },
        {
            "address_1": "631 S Ham Ln Ste B",
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            "country_code": "US",
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        {
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            "telephone_number": "209-365-7867",
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        {
            "address_1": "2339 W Hammer Ln Ste K",
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            "country_code": "US",
            "telephone_number": "209-623-2500",
            "fax_number": "209-222-6182",
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        {
            "address_1": "1700 Keystone Pacific Pkwy Unit C2",
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            "address_1": "1222 W Colony Rd Ste 130",
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        },
        {
            "address_1": "2303 Geer Rd",
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        },
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            "address_1": "1916 N Main St",
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            "state": "CA",
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        },
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            "address_1": "1906 Vista Del Lago Dr Ste A",
            "address_purpose": "LOCATION",
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            "state": "CA",
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            "country_code": "US",
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            "fax_number": "209-772-8533",
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            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GOLDEN BEAR PHYSICAL THERAPY SPORTS INJURY CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-05",
        "last_updated": "2023-12-06",
        "certification_date": "2023-12-06",
        "status": "A",
        "authorized_official_last_name": "ISMAIL",
        "authorized_official_first_name": "BOBBY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "209-353-1988",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark R Goldberg, MD
• Golden Age
• Golden Age Hospice and Comfort Care, Inc.
• Golden Age in Home Care
• Golden Bear Physical Therapy
• Golden Health Clinic
• Golden Health Inc
• Golden Health Medical Inc
• Golden State Hearing Aid Center, Inc.
• Golden State Mobility

• Physical Therapy Clinic/Center in Modesto, CA
• Providers in Modesto, CA by specialty
• Physical Therapy Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.