Healthcare Provider Details

I. General information

NPI: 1134031321
Provider Name (Legal Business Name): PELVITONE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16486 BERNARDO CENTER DR STE 348
SAN DIEGO CA
92128-2530
US

IV. Provider business mailing address

4849 LYON ST
SAN DIEGO CA
92102-2653
US

V. Phone/Fax

Practice location:
  • Phone: 858-588-4845
  • Fax: 858-321-8518
Mailing address:
  • Phone:
  • 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: DANIELLE MARIE OWENS
Title or Position: OWNER858
Credential: DPT
Phone: 856-237-6685