Healthcare Provider Details

I. General information

NPI: 1255140497
Provider Name (Legal Business Name): ERNEST KOCSIS DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/02/2025
Last Update Date: 01/02/2025
Certification Date: 01/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3140 EL CAMINO REAL
CARLSBAD CA
92008-2108
US

IV. Provider business mailing address

1817 AVENIDA DEL DIABLO
ESCONDIDO CA
92029-3112
US

V. Phone/Fax

Practice location:
  • Phone: 760-720-9898
  • Fax:
Mailing address:
  • Phone: 760-580-4007
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT17690
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: