Healthcare Provider Details

I. General information

NPI: 1750103511
Provider Name (Legal Business Name): KNIGHT OSTEOPATHIC HEALING INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/31/2024
Last Update Date: 10/31/2024
Certification Date: 10/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3706 RUFFIN RD
SAN DIEGO CA
92123-1812
US

IV. Provider business mailing address

5815 YOKOHAMA CT
SAN DIEGO CA
92120-3964
US

V. Phone/Fax

Practice location:
  • Phone: 619-964-1321
  • Fax:
Mailing address:
  • Phone: 619-964-1321
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204D00000X
TaxonomyNeuromusculoskeletal Medicine & OMM Physician
License Number
License Number State

VIII. Authorized Official

Name: ROBERT KNIGHT
Title or Position: OWNER
Credential: DO
Phone: 619-964-1321