| South City Physcial Therapy | |
|
443 Grand Ave South San Francisco CA 94080-3635 | |
| (650) 588-9668 | |
| (650) 588-9668 |
| Full Name | South City Physcial Therapy |
|---|---|
| Speciality | Clinic/Center |
| Location | 443 Grand Ave, South San Francisco, California |
| Authorized Official Name and Position | Nimoli Malhotra (OWNER) |
| Authorized Official Contact | 6505889668 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| South City Physcial Therapy 443 Grand Ave South San Francisco CA 94080-3635 Ph: (650) 588-9668 | South City Physcial Therapy 443 Grand Ave South San Francisco CA 94080-3635 Ph: (650) 588-9668 |
| NPI Number | 1932526118 |
|---|---|
| Provider Enumeration Date | 03/25/2014 |
| Last Update Date | 07/26/2023 |
| Medicare PECOS PAC ID | 8123481967 |
|---|---|
| Medicare Enrollment ID | O20230828002064 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932526118 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | PT9873 (California) | Primary |
| Provider Name | Lawrence Smyle |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1659434900 PECOS PAC ID: 6901034404 Enrollment ID: I20140108000203 |
| Provider Name | Lori J Alexander |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1922083864 PECOS PAC ID: 0749410603 Enrollment ID: I20140220001812 |
| Provider Name | Nimoli Malhotra |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1861961492 PECOS PAC ID: 4880930825 Enrollment ID: I20190111000189 |
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