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

Keoni Robert Go-Bulusan

Individual provider Physical Therapist · NPI 1972441806

Keoni Robert Go-Bulusan is a Physical Therapist in Private Practice in Los Gatos, California. Qualified in 2025, 1 year ago. Practices with Ignite Phyzio and Sports Performance Inc, an 8-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
1
Licensed in
CA
In the registry since
2026
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Practice location Address checks out

16185 Los Gatos Blvd Ste 205
Los Gatos, CA 95032-4569
Phone: (866) 525-3175
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 308501 (CA)

Record details

NPI number1972441806
Entity typeIndividual (Type 1)
GenderNot disclosed
Sole proprietorNo
NPI enumeratedMarch 23, 2026
Last updated in NPPESMarch 23, 2026
Certification dateMarch 23, 2026

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice Ignite Phyzio And Sports Performance Inc — 8 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Los Gatos