Type 2 · Organization ✓ Active NPI ✓ Valid NPI checksum

Backtogolf Performance & Fitness Inc

Physical Therapist in Santa Rosa, CA · enumerated 2006 · authorized official Mary Mullnix, Practice Administrator.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1669571188

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Registry record

Entity type Organization (Type 2)

Legal business name Backtogolf Performance & Fitness Inc

Practice address 208 Concourse Blvd, Santa Rosa, CA, 95403

Phone (707) 303-4992

Fax (707) 303-4996

Enumeration date Sep 21, 2006

Last updated in NPPES Apr 14, 2020

Taxonomy & classification

225100000X Physical Therapist Respiratory, Developmental, Rehabilitative and Restorative Service Providers · License PT11380 (CA) Primary

Authorized official

Name Mary Mullnix

Title Practice Administrator

Phone (707) 303-4995

Other identifiers

Identifier	Type	State	Issuer
DB6552	Other	-	RAILROAD MEDICARE GRP #
ZZZ00793Z	Other	CA	BLUE SHIELD GRP ID
P00120133	Other	-	RAILROAD MEDICARE (PIN)
105079200	Other	CA	US DEPT OF LABOR

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

Where is Backtogolf Performance & Fitness Inc located?

The practice location on file with NPPES is in Santa Rosa, CA.

How current is this record?

Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2020-04-14. Verify at npiregistry.cms.hhs.gov.

Providers at this address

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2020-04-14.