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General NPI Number Information
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NPI Number | 1346745981
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Entity Type | Organization
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Legal Business Name | KIM PHYSICAL THERAPY ASSOCIATES, PC
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Dates
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Enumeration Date | 03/27/2018
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Last Update Date | 09/30/2025
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Provider Practice Location Address
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Address Line | 11717 SORRENTO VALLEY RD
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City | SAN DIEGO
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State | CA
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Zip | 92121-1004
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Country | US
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Telephone | 858-847-2025
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Fax | 844-270-6457
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Provider Business Mailing Address
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Address Line | 11717 SORRENTO VALLEY RD
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City | SAN DIEGO
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State | CA
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Zip | 92121-1004
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Country | US
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Telephone | 858-847-2025
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Fax | 844-270-6457
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Authorized Official
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Title or Position | PRESIDENT
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Name | YOUNGSUN KIM
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Credential | DPT
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Telephone | 858-847-2025
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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 | PT30189
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License Number State | CA
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