NPIMap

Organization Active NPI

California Rehabilitation and Sports Therapy a California Physical Ther

  • Multi-Specialty Clinic/Center
  • Benicia, CA
National Provider Identifier
1982563508
Registry record updated Aug 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
CALIFORNIA REHABILITATION AND SPORTS THERAPY A CALIFORNIA PHYSICAL THER
Practice address
816 Southampton Rd
Benicia, CA 94510-1907
Phone
(707) 512-8901
NPI assigned
Jan 20, 2026
Last updated
Aug 12, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2026

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

Authorized official

Name
Nicholas Poan
Title
Cfo
Phone
(945) 260-0010

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

816 Southampton Rd
Benicia, CA 94510-1907

Mailing address

2600 Dallas Pkwy Ste 290
Frisco, TX 75034-7493
Phone (945) 260-0010

Other practice location 1

127 Hospital Dr Ste 101
Vallejo, CA 94589-2500
Phone (707) 512-7290

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040120001115 CA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 6709788896 Receives reassigned benefits from 274 practitioners
25 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Long Beach, CA; Mission Viejo, CA; Newport Beach, CA; Northridge, CA; Norwalk, CA; Orange, CA; Rancho Mission Viejo, CA; Rancho Santa Margarita, CA…

Other NPIs on the same Medicare enrollment 24

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 24

National Provider Directory

National Provider Directory
Tax ID family
California Rehabilitation28 organizations share this tax ID, including this one

Other organizations with this tax ID 27

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

View all 27

Locations

816 Southampton Rd
Benicia, CA 94510
Phone (707) 512-8901

NPI Registry JSON

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

{
    "created_epoch": "1768867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1786492800000",
    "number": "1982563508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 DALLAS PKWY STE 290",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750347493",
            "telephone_number": "945-260-0010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "816 SOUTHAMPTON RD",
            "city": "BENICIA",
            "state": "CA",
            "postal_code": "945101907",
            "telephone_number": "707-512-8901"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "127 Hospital Dr Ste 101",
            "address_purpose": "LOCATION",
            "city": "Vallejo",
            "state": "CA",
            "postal_code": "945892500",
            "country_code": "US",
            "telephone_number": "707-512-7290",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CALIFORNIA REHABILITATION AND SPORTS THERAPY A CALIFORNIA PHYSICAL THER",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-01-20",
        "last_updated": "2026-08-12",
        "certification_date": "2026-08-12",
        "status": "A",
        "authorized_official_last_name": "POAN",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "945-260-0010"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Benicia, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2026; 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.