GOLDEN BEAR PHYSICAL THERAPY SPORTS INJURY CENTER, INC
Complete NPI Record 1811084676
Clinic/Center - Physical Therapy in Modesto, CA

Active since October 05, 2006

4318 SPYRES WAY, MODESTO, CA 95356(209) 576-0710(209) 622-4159 Get Directions

NPPES record last updated: December 6, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 6, 2023, Jul 26, 2022, Apr 19, 2021 and 3 more (6 updates tracked since 2020).

Complete NPI Dataset

This page contains the complete raw NPPES record for Golden Bear Physical Therapy Sports Injury Center, Inc (NPI 1811084676), a clinic/center organization in Modesto, CA. All 29 fields on file are listed with their current values and official NPPES definitions, exactly as recorded in the National Plan and Provider Enumeration System. Only fields that contain data are included, so the number of fields shown varies from one NPI record to another.

Use the tools below to filter fields by category, search within the record, or jump straight to a specific field. You can download the full record as a CSV, JSON, Markdown or text file, or filter first and export only the fields you need. The Print Clean Summary button produces a printer-friendly copy of the record.

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Registry File Document Utilities

NPI: 1811084676: The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Entity Type Code: 2: Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Employer Identification Number EIN: Not available: The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
Provider Organization Name Legal Business Name: GOLDEN BEAR PHYSICAL THERAPY SPORTS INJURY CENTER, INC: The name of the organization provider. If the provider is an organization, this is the legal business name.
Provider First Line Business Mailing Address: PO BOX 52219: The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
Provider Business Mailing Address City Name: PHOENIX: The city name in the mailing address of the provider being identified.
Provider Business Mailing Address State Name: AZ: The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
Provider Business Mailing Address Postal Code: 850722219: The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
Provider Business Mailing Address Country Code If outside U S : US: The country code in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address country code".
Provider Business Mailing Address Telephone Number: 2095760888: The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
Provider Business Mailing Address Fax Number: 2095760913: The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as "Provider location address fax number".
Provider First Line Business Practice Location Address: 4318 SPYRES WAY: The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City Name: MODESTO: The city name in the location address of the provider being identified.
Provider Business Practice Location Address State Name: CA: The State code in the location of the provider being identified.
Provider Business Practice Location Address Postal Code: 953569259: The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code If outside U S : US: The country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number: 2095760710: The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number: 2096224159: The fax number associated with the location address of the provider being identified.
Provider Enumeration Date: 10/5/2006: The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date: 12/6/2023: The date that a record was last updated or changed.
Authorized Official Last Name: ISMAIL: The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Authorized Official First Name: BOBBY: The first name of the authorized official.
Authorized Official Title or Position: CEO: The title or position of the authorized official.
Authorized Official Telephone Number: 2093531988: The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code 1: 261QP2000X: This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
Healthcare Provider Primary Taxonomy Switch 1: Y: This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
Is Organization Subpart: N: Indicates whether the provider is a subpart of a larger organization. This is a single-character code: "Y" means the entity is an organizational subpart, while "N" means it is not. Subparts typically include hospital departments, clinics, or other distinct units that fall under a parent organization.
Authorized Official Credential Text: DPT: The professional credential(s) of the authorized official listed on the provider's NPI record. Examples include MD (Doctor of Medicine), DO (Doctor of Osteopathy), RN (Registered Nurse), DDS (Doctor of Dental Surgery), PhD, or other recognized designations that reflect the official's qualifications.
NPI Certification Date: 12/6/2023: The date on which the National Provider Identifier (NPI) was officially assigned and certified to the provider. This reflects when the provider's NPI record first became active in the NPPES system.

Secondary Practice Locations 25

The first line of the secondary practice location address of the provider being identified. For providers with more than one physical location, this is a secondary practice location address. This address cannot include a Post Office box.

1229 Commerce Ave

1/25

Atwater, CA 95301-5224 · Phone (209) 683-1386 · Fax (209) 222-6185

1335 Coffee Rd Ste 200

2/25

Modesto, CA 95355-3192 · Phone (209) 576-1946 · Fax (209) 622-4159

1533 Oakdale Rd Ste B

3/25

Modesto, CA 95355-3305 · Phone (209) 554-5233 · Fax (209) 622-4159

2119 E Hatch Rd Ste A

4/25

Modesto, CA 95351-4814 · Phone (209) 812-3055 · Fax (209) 537-2820

146 N Maag Ave Ste B

5/25

Oakdale, CA 95361-2249 · Phone (209) 322-2140 · Fax (209) 622-4159

1519 W Yosemite Ave

6/25

Manteca, CA 95337-5159 · Phone (209) 823-3322 · Fax (209) 222-6182

1019 S Main St

7/25

Manteca, CA 95337-5703 · Phone (209) 624-1002 · Fax (209) 222-6182

3184 Collins Dr

8/25

Merced, CA 95348-3132 · Phone (209) 230-5289 · Fax (209) 222-6185

2908 E Whitmore Ave Ste E

9/25

Ceres, CA 95307-2800 · Phone (209) 622-4149 · Fax (209) 622-4159

2222 Francisco Dr

10/25

El Dorado Hills, CA 95762-3762 · Phone (916) 235-4071 · Fax (916) 934-0802

4080 N Cedar Ave

11/25

Fresno, CA 93726-5267 · Phone (559) 222-7497 · Fax (559) 224-9310

468 Winton Pkwy

12/25

Livingston, CA 95334-9809 · Phone (209) 398-8740 · Fax (209) 222-6185

631 S Ham Ln Ste B

13/25

Lodi, CA 95242-3532 · Phone (209) 368-7433 · Fax (209) 222-6182

210 W Pine St

14/25

Lodi, CA 95240-2020 · Phone (209) 365-7867 · Fax (209) 222-6182

1400 S Mercey Springs Rd Ste I

15/25

Los Banos, CA 93635-4928 · Phone (209) 710-1011 · Fax (209) 222-6185

1700 Keystone Pacific Pkwy Unit C2

16/25

Patterson, CA 95363-8874 · Phone (209) 895-4206 · Fax (209) 222-6185

1222 W Colony Rd Ste 130

17/25

Ripon, CA 95366-9482 · Phone (096) 241-2882 · Fax (096) 224-1592

1586 Constitution Blvd

18/25

Salinas, CA 93905-3803 · Phone (831) 276-0565 · Fax (209) 222-6185

2339 W Hammer Ln Ste K

19/25

Stockton, CA 95209-2368 · Phone (209) 623-2500 · Fax (209) 222-6182

855 S Tracy Blvd

20/25

Tracy, CA 95376-4744 · Phone (209) 627-1383 · Fax (209) 222-6182

2603 Patterson Rd Ste 8

21/25

Riverbank, CA 95367-3407 · Phone (209) 896-1870 · Fax (209) 622-4159

3800 Geer Rd Ste 101

22/25

Turlock, CA 95382-1146 · Phone (209) 667-1729 · Fax (209) 222-6185

2303 Geer Rd

23/25

Turlock, CA 95382-2408 · Phone (209) 585-4100 · Fax (209) 222-6185

1916 N Main St

24/25

Salinas, CA 93906-2034 · Phone (209) 508-9573 · Fax (209) 222-6185

1906 Vista Del Lago Dr Ste A

25/25

Valley Springs, CA 95252-9700 · Phone (209) 584-1007 · Fax (209) 772-8533

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