Healthcare Provider Details

I. General information

NPI: 1144530668
Provider Name (Legal Business Name): STERNER MOVEMENT SPECIALIST, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/18/2010
Last Update Date: 11/21/2024
Certification Date: 11/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16389 BERNARDO CENTER DR
SAN DIEGO CA
92128-2541
US

IV. Provider business mailing address

12833 ABRA PL
SAN DIEGO CA
92128-2330
US

V. Phone/Fax

Practice location:
  • Phone: 858-531-9548
  • Fax:
Mailing address:
  • Phone: 858-531-9548
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number29374
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name: MR. GREGORY CHARLES STERNER
Title or Position: PRESIDENT
Credential: PT
Phone: 858-531-9548