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

Individual provider Physical Therapist · NPI 1982771481

Mr. Rustem Ixanov, MS, PT is a Physical Therapist in Santa Rosa, California. Licensed in California. Registered with an NPI since 2006.

Licensed in
CA
In the registry since
2006
What do these letters mean?
MS — Master of Science
A graduate science degree.
PT — Physical Therapist
A licensed therapist who treats movement, pain and injury.

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Practice location Address checks out

3550 Round Barn Blvd # 112
Santa Rosa, CA 95403-1796
Phone: (707) 566-5488
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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 PT 32358 (CA)

Record details

NPI number1982771481
Entity typeIndividual (Type 1)
GenderMale
Credentials MS , PT
Sole proprietorNo
NPI enumeratedNovember 29, 2006
Last updated in NPPESNovember 16, 2021
Certification dateNovember 16, 2021

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