Basic Information
| Provider Information | |||||||||
| NPI: | 1174982433 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KARNEY | ||||||||
| FirstName: | GREGORY | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | PT. DPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7373 COVEY RD | ||||||||
| Address2: | |||||||||
| City: | FORESTVILLE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 954369587 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7605052656 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1550 SILVEIRA PKWY | ||||||||
| Address2: | |||||||||
| City: | SAN RAFAEL | ||||||||
| State: | CA | ||||||||
| PostalCode: | 949034879 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4154991000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/15/2016 | ||||||||
| LastUpdateDate: | 02/15/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 42240 | CA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.