Healthcare Provider Details
I. General information
NPI: 1386490761
Provider Name (Legal Business Name): DEL DIOS THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/26/2024
Last Update Date: 04/26/2024
Certification Date: 04/26/2024
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
- Phone: 760-720-9898
- Fax:
- Phone: 442-277-0190
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QR0400X |
| Taxonomy | Rehabilitation Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SARA
DEVINE
STIGLICH
Title or Position: PROGRAM DIRECTOR
Credential: OTR/L
Phone: 760-580-4007