Provider Type Icon

PTR SPORTS A MEDICAL CORPORATION NPI 1083750764


NPI Information

NPI: 1083750764
Provider Name: PTR SPORTS, A MEDICAL CORPORATION
Classification: Family Medicine - 207QS0010X
Entity Type: Organization

Specialization: Sports Medicine

Address:
1825 CIVIC CENTER DR
SUITE 25
SANTA CLARA, CA
ZIP 95050
Phone: (408) 404-4700
Get Directions

PTR SPORTS, A MEDICAL CORPORATION is a sports medicine family medicine in Santa Clara, CA. The provider is a family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation. PTR SPORTS, A MEDICAL CORPORATION NPI is 1083750764. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1825 CIVIC CENTER DR
SUITE 25
SANTA CLARA, CA
ZIP 95050-301
Phone: (408) 404-4700
Fax: (408) 404-4701

The provider's authorized official is Jeffrey G Blue .
The authorized official title is President and has the following contact phone number (408) 404-4700.

The enumeration date for this NPI number is 1/29/2007 and was last updated on 10/28/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207QS0010XFamily MedicineSports MedicineYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1ZZZ28590ZMEDICARE ID-TYPE UNSPECIFIEDCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.