Healthcare Provider Details

I. General information

NPI: 1083038764
Provider Name (Legal Business Name): RISE PHYSICAL THERAPY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2014
Last Update Date: 05/21/2025
Certification Date: 05/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

380 STEVENS AVE SUITE 314
SOLANA BEACH CA
92075-2063
US

IV. Provider business mailing address

380 STEVENS AVE SUITE 314
SOLANA BEACH CA
92075-2063
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number38257
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2251G0304X
TaxonomyGeriatric Physical Therapist
License Number38257
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code2251N0400X
TaxonomyNeurology Physical Therapist
License Number38257
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number38257
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License Number38257
License Number StateCA
# 6
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number38257
License Number StateCA
# 7
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: PAUL ROH
Title or Position: OWNER
Credential:
Phone: 858-755-5200