Healthcare Provider Details

I. General information

NPI: 1710891841
Provider Name (Legal Business Name): CAMERON SCOTT VETTER DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5550 CARMEL MOUNTAIN RD STE 208
SAN DIEGO CA
92130-4861
US

IV. Provider business mailing address

380 STEVENS AVE STE 314
SOLANA BEACH CA
92075-2069
US

V. Phone/Fax

Practice location:
  • Phone: 858-755-5200
  • Fax: 858-314-9611
Mailing address:
  • Phone: 858-755-5200
  • Fax: 858-755-5201

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number311092
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: