Provider Demographics
NPI:1144848128
Name:TIM HORNAK
Entity type:Organization
Organization Name:TIM HORNAK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:TIM
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:HORNAK
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:408-294-3922
Mailing Address - Street 1:25 N 14TH ST STE 550
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95112-6206
Mailing Address - Country:US
Mailing Address - Phone:408-294-3922
Mailing Address - Fax:408-294-4657
Practice Address - Street 1:25 N 14TH ST STE 550
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95112-6206
Practice Address - Country:US
Practice Address - Phone:408-294-3922
Practice Address - Fax:408-294-4657
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-07
Last Update Date:2020-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Single Specialty