Healthcare Provider Details

I. General information

NPI: 1073207288
Provider Name (Legal Business Name): HELLER PHYSICAL THERAPY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2023
Last Update Date: 06/30/2023
Certification Date: 06/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2535 CAMINO DEL RIO S STE 225
SAN DIEGO CA
92108-3756
US

IV. Provider business mailing address

3711 LOUISIANA ST UNIT 5
SAN DIEGO CA
92104-5918
US

V. Phone/Fax

Practice location:
  • Phone: 347-820-5291
  • Fax:
Mailing address:
  • Phone: 347-820-5291
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. DANIEL LEVY HELLER
Title or Position: OWNER
Credential: DPT
Phone: 347-820-5291