Healthcare Provider Details

I. General information

NPI: 1821429119
Provider Name (Legal Business Name): SEAN WILLIAM KUHN JR. PT, DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/11/2013
Last Update Date: 07/03/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4876 SANTA MONICA AVE # 204
SAN DIEGO CA
92107-2811
US

IV. Provider business mailing address

4876 SANTA MONICA AVE # 204
SAN DIEGO CA
92107-2811
US

V. Phone/Fax

Practice location:
  • Phone: 619-578-2880
  • Fax: 619-578-2880
Mailing address:
  • Phone: 619-578-2880
  • Fax: 619-578-2880

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number40879
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: