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General NPI Number Information
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NPI Number | 1629618723
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Entity Type | Organization
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Legal Business Name | BREAKINGTHROUGH SAN DIEGO PHYSICAL THERAPY
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Dates
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Enumeration Date | 01/07/2020
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Last Update Date | 01/07/2020
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Provider Practice Location Address
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Address Line | 2424 VISTA WAY STE 120
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City | OCEANSIDE
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State | CA
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Zip | 92054-6178
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Country | US
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Telephone | 551-574-7459
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Fax |
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Provider Business Mailing Address
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Address Line | 2424 VISTA WAY STE 120
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City | OCEANSIDE
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State | CA
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Zip | 92054-6178
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Country | US
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Telephone | 551-574-7459
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPIST/OWNER
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Name | DR. SANTIAGO OSORIO
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Credential | PT, DPT
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Telephone | 551-574-7459
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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 |
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License Number State |
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