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General NPI Number Information
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NPI Number | 1255446977
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Entity Type | Individual
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Provider Name | MOLLIE ANNE FITZSIMMONS DPT
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Gender | Female
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Dates
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Enumeration Date | 08/20/2006
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Last Update Date | 05/19/2021
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Provider Practice Location Address
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Address Line | 5650 EL CAMINO REAL STE 120
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City | CARLSBAD
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State | CA
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Zip | 92008-7126
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Country | US
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Telephone | 760-919-2688
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Fax | 760-502-6552
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Provider Business Mailing Address
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Address Line | 5650 EL CAMINO REAL STE 120
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City | CARLSBAD
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State | CA
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Zip | 92008-7126
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Country | US
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Telephone | 760-919-2688
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Fax | 760-814-8069
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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 | 24156
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License Number State | CA
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