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General NPI Number Information
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NPI Number | 1245119221
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Entity Type | Individual
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Provider Name | DALLEY THOMPSON PTA
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Gender | Male
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Dates
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Enumeration Date | 09/02/2025
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Last Update Date | 09/02/2025
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Provider Practice Location Address
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Address Line | 2240 E PLAZA BLVD STE B
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City | NATIONAL CITY
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State | CA
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Zip | 91950-5165
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Country | US
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Telephone | 619-474-5916
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Fax |
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Provider Business Mailing Address
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Address Line | 1281 9TH AVE UNIT 2311
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City | SAN DIEGO
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State | CA
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Zip | 92101-4669
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Country | US
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Telephone | 619-757-9303
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Fax |
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 53183
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License Number State | CA
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