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NPI Code Detail

MEDICARE: CALIFORNIA SPORTS PHYSICAL THERAPY CENTERS INC

MEDICARE: CALIFORNIA SPORTS PHYSICAL THERAPY CENTERS INC
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
1261QM1300XMulti-Specialty Clinic/Center
2261QP2000XPhysical Therapy Clinic/Center

General Provider Information

NPI Number : 1851022990
Entity Type Code : Organization
Provider Name (Legal Business Name) : CALIFORNIA SPORTS PHYSICAL THERAPY CENTERS INC
Provider Business Mailing Address
First Line : 2035 CORTE DEL NOGAL STE 200
Second Line :
City : CARLSBAD
State : CA
Zip : 92011-1445
Country : US
Telephone Number : 760-931-8310
Fax Number :
Provider Business Practice Location Address
First Line : 101 WILSON RD STE C
Second Line :
City : MONTEREY
State : CA
Zip : 93940-7864
Country : US
Telephone Number : 408-889-1367
Fax Number : 408-912-2043
Authorized Official
Title or Position : OWNER
Name : ROBERT PACE
Credential :
Telephone Number : 213-804-1712
Provider Enumeration Date : 06/20/2022
Last Update Date : 06/20/2022

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Directions to “CALIFORNIA SPORTS PHYSICAL THERAPY CENTERS INC ” Practice Location

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