Healthcare Provider Details

I. General information

NPI: 1083704167
Provider Name (Legal Business Name): SEAN M HILL MPT, CSCS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: SEAN MICHAEL HILL

II. Dates (important events)

Enumeration Date: 10/13/2006
Last Update Date: 04/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3959 RUFFIN RD STE F
SAN DIEGO CA
92123-1830
US

IV. Provider business mailing address

3959 RUFFIN RD SUITE F
SAN DIEGO CA
92123-1830
US

V. Phone/Fax

Practice location:
  • Phone: 858-279-5570
  • Fax: 858-279-5303
Mailing address:
  • Phone: 858-279-5570
  • Fax: 585-279-5303

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT26678
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2251G0304X
TaxonomyGeriatric Physical Therapist
License NumberPT26678
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License NumberPT26678
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License NumberPT26678
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License NumberPT26678
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: