Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Keith Edward Sullivan, DPT

Individual provider Orthopedic Physical Therapist · NPI 1164823738

Keith Edward Sullivan, DPT is a Physical Therapist in Private Practice in San Bruno, California. Qualified in 2010, 16 years ago. Practices with Permanente Medical Group Inc, a 10,941-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
16
Licensed in
CA
In the registry since
2014
What do these letters mean?
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

See every abbreviation used in this directory →

Practice location Address checks out

1001 Sneath Ln
San Bruno, CA 94066-2308
Phone: (650) 871-8645
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Orthopedic Physical Therapist (primary) Taxonomy 2251X0800X · Licence 37244 (CA)

Record details

NPI number1164823738
Entity typeIndividual (Type 1)
GenderMale
Credentials DPT
Sole proprietorNo
NPI enumeratedSeptember 15, 2014
Last updated in NPPESJanuary 3, 2022
Mailing address1717 Los Altos Dr, San Mateo, CA 94402-3602

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2010 (16 years in practice)
Group practice Permanente Medical Group Inc — 10941 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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