Healthcare Provider Details

I. General information

NPI: 1740242510
Provider Name (Legal Business Name): DEL MAR PHYSICAL THERAPY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/05/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

317 14TH ST
DEL MAR CA
92014-2554
US

IV. Provider business mailing address

317 14TH ST
DEL MAR CA
92014-2554
US

V. Phone/Fax

Practice location:
  • Phone: 858-755-1229
  • Fax: 858-755-0720
Mailing address:
  • Phone: 858-755-1229
  • Fax: 858-755-0720

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number
License Number State

VIII. Authorized Official

Name: MS. ALI QUINTAS
Title or Position: BUSINESS MANAGER
Credential:
Phone: 858-755-1229