Provider Demographics
NPI:1861559940
Name:SOO, BRIAN EUGENE (MPT)
Entity type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:EUGENE
Last Name:SOO
Suffix:
Gender:M
Credentials:MPT
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Mailing Address - Street 1:1635 DIVISADERO ST STE 300
Mailing Address - Street 2:#300
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-3043
Mailing Address - Country:US
Mailing Address - Phone:415-833-3064
Mailing Address - Fax:
Practice Address - Street 1:1635 DIVISADERO ST
Practice Address - Street 2:SUITE #300
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-3036
Practice Address - Country:US
Practice Address - Phone:415-833-3064
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2021-12-30
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic