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General NPI Number Information
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NPI Number | 1598572877
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Entity Type | Organization
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Legal Business Name | EL CAJON PHYSICAL THERAPY APC
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Dates
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Enumeration Date | 12/11/2024
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Last Update Date | 06/18/2025
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Provider Practice Location Address
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Address Line | 353 E PARK AVE STE 104
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City | EL CAJON
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State | CA
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Zip | 92020-3944
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Country | US
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Telephone | 619-647-8854
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Fax |
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Provider Business Mailing Address
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Address Line | 353 E PARK AVE STE 104
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City | EL CAJON
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State | CA
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Zip | 92020-3944
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Country | US
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Telephone | 619-647-8854
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Fax |
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Authorized Official
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Title or Position | CHIEF OPERATING OFFICER
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Name | PETER GIBO
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Credential |
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Telephone | 619-647-8854
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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