Doctor Name: | TREVOR BOSTDORF |
NPI Number: | 1205819513 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MPT/MTC |
License Number: | PT24420 |
Business Practice Address: | 14901 National Ave Suite 102 Los Gatos, CA - 950322637 |
Business Phone Number: | 4083583631 |
Business Fax Number: | 4083584537 |
Mailing Address: | 14901 National Ave, Suite 102 LOS GATOS |
State: | CA |
Postal Code: | 950322637 |
Phone Number: | 4083583631 |
Fax Number: | 4083584537 |
NPI Enumeration Date: | 11/22/2005 |
NPI Last Update Date: | 04/15/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | PT24420 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |