PTR SPORTS, A MEDICAL CORPORATION


Address: 1825 Civic Center Dr, Suite 25, Santa Clara, CA 95050-7301
Phone: 4084044700

PTR SPORTS, A MEDICAL CORPORATION (NPI# 1083750764) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1083750764
Entity Type Organization
Organization Name PTR SPORTS, A MEDICAL CORPORATION
Practice Address 1825 Civic Center Dr
Suite 25
Santa Clara
CA 95050-7301
Practice Telephone 4084044700
Practice Fax Number 4084044701
Mailing Telephone 4084044700
Mailing Fax Number 4084044701
Enumeration Date 2007-01-29
Last Update Date 2008-10-28
Authorized Official Name JEFFREY G BLUE (PRESIDENT)
Authorized Official Telephone 4084044700
Authorized Official Credential M.D.
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207QS0010X Family Medicine
Specialization: Sports Medicine
Allopathic & Osteopathic Physicians

Office Location

Street Address 1825 CIVIC CENTER DR
SUITE 25
City SANTA CLARA
State CA
Zip Code 95050-7301

Providers in the same location

NPI Name Taxonomy Address Enumeration
1457324931 Donna Nissley Nchekwube General Practice 1825 Civic Center Dr, 17, Santa Clara, CA 95050-7301 2006-02-07
1851574289 Jan Kenneth Klofter Physical Therapist 1825 Civic Center Dr, Santa Clara, CA 95050-7301 2007-12-07
1447430954 William H Trolan Md Inc. Clinic/Center 1825 Civic Center Dr, Suite # 7, Santa Clara, CA 95050-7301 2007-11-13
1194917369 E and D Nchekwube, Md, Inc General Practice 1825 Civic Center Dr, #17, Santa Clara, CA 95050-7302 2007-08-13
1801900220 Jeffrey G Blue Family Medicine 1825 Civic Center Dr, Suite 25, Santa Clara, CA 95050-7301 2006-08-19
1568479327 Khaliq A. Shah Internal Medicine 1825 Civic Center Dr, Suite 13, Santa Clara, CA 95050-7301 2006-08-02
1306819826 Emeka J Nchekwube Neurological Surgery 1825 Civic Center Dr, 17, Santa Clara, CA 95050-7301 2006-02-08

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1902446115 Amanda Tatiana Perez Behavior Technician 126. Main St, Santa Clara, CA 95050 2020-01-15
1942854013 Beatrice M Roque Behavior Technician 1171 Homestead Rd Ste.250, Santa Clara, CA 95050 2019-07-27
1619433836 Angelica Chavez Behavioral Analyst 1171 Homested Rd Ste 250, San Jose, CA 95050 2019-02-12
1578047551 Tran and Nguyen Dental Corporation Dentist 1171 Homestead Rd Suite #214, Santa Clara, CA 95050 2018-09-17
1467938431 Yvette Garcia Behavioral Analyst 1171 Homestead Ave #250, Santa Clara, CA 95050 2018-07-12
1174016117 Kahrizak Foundation Inc. Assisted Living Facility 1818 Scott Blvd, Santa Clara, CA 95050 2018-06-13
1194217620 Diana Urias Behavioral Analyst 1151 Homestead Rd Ste 250, Santa Clara, CA 95050 2018-05-31
1801321583 Alexandra Araujo Behavior Technician 962 Reeve St, Santa Clara, CA 95050 2017-05-01
1366830127 Christina Altemueller Marriage & Family Therapist 2797 Park Avenue, Suite 200, Santa Clara, CA 95050 2015-01-02
1922411503 Olivia Brown Krakower Speech-Language Pathologist 1880 Pruneridge Avenue, Santa Clara, CA 95050 2014-06-11
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Taxonomy Information

Taxonomy Code 207QS0010X
Grouping Allopathic & Osteopathic Physicians
Classification Family Medicine
Specialization Sports Medicine

Taxonomy Definition

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.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source]
- Additional Resources: American Board of Family Medicine, 2007. http://www.theabfm.org/. American Osteopathic Board of Family Medicine, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Medicine.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1710203245 Malcolm Medical Group Family Medicine 1150 Scott Blvd Ste D1, Santa Clara, CA 95050-4547 2010-04-08
1801900220 Jeffrey G Blue Family Medicine 1825 Civic Center Dr, Suite 25, Santa Clara, CA 95050-7301 2006-08-19

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1447875570 Nader Sobh Inc Family Medicine 11740 San Vicente Blvd Ste 205, Los Angeles, CA 90049-6610 2020-06-15
1124596010 Cam Md Family Medicine 1968 S Coast Hwy # 401, Laguna Beach, CA 92651-3681 2018-11-08
1902289226 Daesoon Leem Family Medicine 15095 Amargosa Rd, Bldg.1, #102, Victorville, CA 92394 2015-07-06
1114313616 Michelle Sriwongtong Family Medicine 834 Castro St, 3, San Francisco, CA 94114-2858 2015-04-10
1225433006 Harut Madatovian Family Medicine 2595 E Washington Blvd Ste 106, Pasadena, CA 91107-1409 2014-10-23
1760801880 Kyle William Meyer Family Medicine 24910 Las Brisas Rd Ste 105, Murrieta, CA 92562 2014-04-16
1720403553 Dianne Longo Family Medicine 1319 Evergreen Ave, Apt N2, Fullerton, CA 92835-2063 2014-03-03
1255760633 Steven William Marles Family Medicine 4265 Tapestry Way, Turlock, CA 95382-7448 2013-11-05
1497098909 Joshua David Sampson Family Medicine 2299 Post St Ste 107, San Francisco, CA 94115-3460 2013-04-03
1699015529 Andrew Saleh Family Medicine 1370 Rosecrans St Ste A, San Diego, CA 92106-2676 2013-03-01
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Competitor

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City SANTA CLARA
Zip Code 95050

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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