Healthcare Provider Details

I. General information

NPI: 1053825737
Provider Name (Legal Business Name): KUHN PHYSICAL THERAPY AND WELLNESS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/16/2017
Last Update Date: 07/03/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4879 CORONADO AVE
SAN DIEGO CA
92107-3315
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 619-895-8094
  • Fax:
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: DR. SEAN WILLIAM KUHN JR.
Title or Position: OWNER/FOUNDING MEMBER
Credential: PT, DPT
Phone: 619-895-8094