Healthcare Provider Details

I. General information

NPI: 1770520496
Provider Name (Legal Business Name): EGGLETON & LANGTON PHYSICAL THERAPY MANAGEMENT SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2006
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15373 INNOVATION DR STE 220
SAN DIEGO CA
92128-3425
US

IV. Provider business mailing address

5905 SEVERIN DR
LA MESA CA
91942-3806
US

V. Phone/Fax

Practice location:
  • Phone: 858-592-8855
  • Fax: 858-592-8858
Mailing address:
  • Phone: 619-589-2606
  • Fax: 619-464-0900

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name: ROB PACE
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 760-268-7500