Healthcare Provider Details

I. General information

NPI: 1740830975
Provider Name (Legal Business Name): BEST PERFORMANCE AND PHYSICAL THERAPY P C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2019
Last Update Date: 07/08/2020
Certification Date: 07/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

119 ABERDEEN DR
CARDIFF BY THE SEA CA
92007-1841
US

IV. Provider business mailing address

119 ABERDEEN DR
CARDIFF BY THE SEA CA
92007-1841
US

V. Phone/Fax

Practice location:
  • Phone: 760-452-6551
  • Fax: 760-452-6461
Mailing address:
  • Phone: 760-452-6551
  • Fax: 760-452-6461

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MELISSA JACKA
Title or Position: PHYSICAL THERAPIST
Credential: DPT
Phone: 316-619-7183