MEDICARE: CHELSEA RENEE AYRES 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	2251X0800X	Orthopedic Physical Therapist	293511	CA
2	225100000X	Physical Therapist	293511	CA

General Provider Information

NPI Number	:	1811413644
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHELSEA RENEE AYRES DPT

Provider Business Mailing Address
First Line	:	12831 STONE CANYON RD
Second Line	:
City	:	POWAY
State	:	CA
Zip	:	92064-2014
Country	:	US
Telephone Number	:	858-829-7435
Fax Number	:

Provider Business Practice Location Address
First Line	:	13350 CAMINO DEL SUR STE 1
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92129-4473
Country	:	US
Telephone Number	:	858-790-8549
Fax Number	:

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

Provider Enumeration Date	:	08/14/2017
Last Update Date	:	12/22/2020

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Directions to “ CHELSEA RENEE AYRES DPT” Practice Location

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