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NPI 1649865643

NPI 1649865643 : TIMOTHY ALEXANDER WERTZ PT, DPT : CAMP PENDLETON, CA

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General NPI Number Information
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    NPI Number           |    1649865643
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    Entity Type          |    Individual 
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    Provider Name        |    TIMOTHY ALEXANDER WERTZ PT, DPT
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    03/02/2021
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    Last Update Date     |    12/11/2025
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Provider Practice Location Address
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    Address Line         |    200 MERCY CIRCLE 
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    City                 |    CAMP PENDLETON
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    State                |    CA
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    Zip                  |    92055-5191
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    Country              |    US
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    Telephone            |    760-725-1288
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    200 MERCY CIRCLE 
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    City                 |    CAMP PENDLETON
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    State                |    CA
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    Zip                  |    92055-5191
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    Country              |    US
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    Telephone            |    760-725-1288
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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        |    2251S0007X
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    Taxonomy Name        |    Sports Physical Therapist
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    License Number       |    299452
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    License Number State |    CA
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Taxonomy #2
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    Taxonomy Code        |    2251X0800X
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    Taxonomy Name        |    Orthopedic Physical Therapist
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    License Number       |    299452
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    License Number State |    CA
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Taxonomy #3
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    Taxonomy Code        |    225100000X
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    Taxonomy Name        |    Physical Therapist
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    License Number       |    299452
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    License Number State |    CA
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Taxonomy #4
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    Taxonomy Code        |    2251E1200X
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    Taxonomy Name        |    Ergonomics Physical Therapist
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    License Number       |    299452
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    License Number State |    CA
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