Healthcare Provider Details

I. General information

NPI: 1942930656
Provider Name (Legal Business Name): SELECT SAN DIEGO PHYSICAL THERAPY, PC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2022
Last Update Date: 10/28/2025
Certification Date: 10/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10538 MISSION GORGE RD STE 120
SANTEE CA
92071-3154
US

IV. Provider business mailing address

4714 GETTYSBURG RD
MECHANICSBURG PA
17055-4325
US

V. Phone/Fax

Practice location:
  • Phone: 619-312-6109
  • Fax: 619-312-6110
Mailing address:
  • Phone: 717-972-1100
  • 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: ALLEN CARPENTER
Title or Position: VICE PRESIDENT
Credential:
Phone: 717-972-1100