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General NPI Number Information
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NPI Number | 1194727305
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Entity Type | Individual
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Provider Name | NORMA KHALIFE ROUILLARD PT
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Gender | Female
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Dates
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Enumeration Date | 06/01/2005
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Last Update Date | 11/27/2019
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Provider Practice Location Address
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Address Line | 8790 CUYAMACA ST SUITE A
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City | SANTEE
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State | CA
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Zip | 92071-4295
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Country | US
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Telephone | 619-596-5969
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Fax | 619-596-5970
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Provider Business Mailing Address
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Address Line | 3760 CONVOY ST STE 101
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City | SAN DIEGO
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State | CA
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Zip | 92111-3743
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Country | US
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Telephone | 888-208-8526
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Fax | 858-751-0901
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT 29262
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License Number State | CA
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