MEDICARE: DOBROMIRA ANDREEVA ARSOVA PT, DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2251P0200X	Pediatric Physical Therapist	306035	CA

General Provider Information

NPI Number	:	1003640186
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DOBROMIRA ANDREEVA ARSOVA PT, DPT

Provider Business Mailing Address
First Line	:	3967 LAMONT ST APT 3
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92109-6194
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6977 NAVAJO RD # 445
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92119-1503
Country	:	US
Telephone Number	:	858-848-9917
Fax Number	:	858-987-8653

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/29/2024
Last Update Date	:	08/29/2024

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