Provider Demographics
NPI:1730973900
Name:FORGE PHYSICAL THERAPY PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:FORGE PHYSICAL THERAPY PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MINGXI
Authorized Official - Middle Name:
Authorized Official - Last Name:LI
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:646-266-7528
Mailing Address - Street 1:1455 FILBERT ST APT 302
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94109-1661
Mailing Address - Country:US
Mailing Address - Phone:646-266-7528
Mailing Address - Fax:
Practice Address - Street 1:500 TAMAL PLZ STE 524
Practice Address - Street 2:
Practice Address - City:CORTE MADERA
Practice Address - State:CA
Practice Address - Zip Code:94925-1187
Practice Address - Country:US
Practice Address - Phone:646-266-7528
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-04
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty