Provider Demographics
NPI:1902889116
Name:GILES, THOMAS PAGE (PT)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:PAGE
Last Name:GILES
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:605 TENNANT AVE
Mailing Address - Street 2:STE F
Mailing Address - City:MORGAN HILL
Mailing Address - State:CA
Mailing Address - Zip Code:95037-5529
Mailing Address - Country:US
Mailing Address - Phone:408-778-3434
Mailing Address - Fax:408-778-3464
Practice Address - Street 1:605 TENNANT AVE
Practice Address - Street 2:STE F
Practice Address - City:MORGAN HILL
Practice Address - State:CA
Practice Address - Zip Code:95037-5529
Practice Address - Country:US
Practice Address - Phone:408-778-3434
Practice Address - Fax:408-778-3464
Is Sole Proprietor?:No
Enumeration Date:2005-11-22
Last Update Date:2015-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT12238225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ21439ZOtherMEDICARE GROUP PTAN
CA0PT122380Medicare PIN