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NPI 1609216688

NPI 1609216688 : DALE NITZEL ATC : SAN DIEGO, CA

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General NPI Number Information
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    NPI Number           |    1609216688
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    Entity Type          |    Individual 
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    Provider Name        |    DALE NITZEL ATC
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    07/05/2013
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    Last Update Date     |    12/18/2025
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Provider Practice Location Address
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    Address Line         |    34800 BOB WILSON DR 
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    City                 |    SAN DIEGO
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    State                |    CA
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    Zip                  |    92134-1098
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    Country              |    US
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    Telephone            |    619-556-8096
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    2466 CALLE AGUADULCE 
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    City                 |    SAN DIEGO
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    State                |    CA
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    Zip                  |    92139-2211
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    Country              |    US
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    Telephone            |    619-885-0911
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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        |    2255A2300X
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    Taxonomy Name        |    Athletic Trainer
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    License Number       |    
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    License Number State |    CA
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