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General NPI Number Information
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NPI Number | 1609178169
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Entity Type | Individual
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Provider Name | KRISTOPHER NEAL MOECKEL MPT
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Gender | Male
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Dates
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Enumeration Date | 12/03/2010
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Last Update Date | 12/06/2021
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Provider Practice Location Address
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Address Line | 10992 SAN DIEGO MISSION RD
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City | SAN DIEGO
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State | CA
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Zip | 92108-2444
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Country | US
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Telephone | 619-241-1832
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Fax |
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Provider Business Mailing Address
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Address Line | 7120 SHORELINE DR #2105
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City | SAN DIEGO
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State | CA
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Zip | 92122-4902
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Country | US
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Telephone | 760-927-6730
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT 26621
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License Number State | CA
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