Healthcare Provider Details

I. General information

NPI: 1750199535
Provider Name (Legal Business Name): EVERYDAY SPORTS PERFORMANCE & PHYSICAL THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/24/2024
Last Update Date: 12/24/2024
Certification Date: 12/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7420 CLAIREMONT MESA BLVD STE 109
SAN DIEGO CA
92111-1546
US

IV. Provider business mailing address

7120 SHORELINE DR UNIT 2203
SAN DIEGO CA
92122-4904
US

V. Phone/Fax

Practice location:
  • Phone: 858-218-6522
  • Fax:
Mailing address:
  • Phone: 714-618-4347
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: HAYDEN DUMAYAG
Title or Position: OWNER
Credential: PT, DPT, CSCS
Phone: 858-218-6522