Healthcare Provider Details
I. General information
NPI: 1649284233
Provider Name (Legal Business Name): RACHEL ZILKA P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/28/2006
Last Update Date: 12/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3880 VALLEY CENTRE DR STE 201
SAN DIEGO CA
92130-3310
US
IV. Provider business mailing address
9237 REGENTS RD APT K-114
LA JOLLA CA
92037
US
V. Phone/Fax
- Phone: 858-793-1460
- Fax: 858-793-1989
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | PT010817 |
| License Number State | OH |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | PT34071 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: