Healthcare Provider Details

I. General information

NPI: 1750120051
Provider Name (Legal Business Name): REHAB UNITED SPORTS MEDICINE & PHYSICAL THERAPY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2024
Last Update Date: 05/24/2024
Certification Date: 05/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5850 EL CAMINO REAL STE 111
CARLSBAD CA
92008-8816
US

IV. Provider business mailing address

3959 RUFFIN RD STE J
SAN DIEGO CA
92123-1830
US

V. Phone/Fax

Practice location:
  • Phone: 760-542-2414
  • Fax: 760-542-2415
Mailing address:
  • Phone: 858-279-5570
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: BRYAN S HILL
Title or Position: CEO
Credential: PT
Phone: 858-279-5570