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General NPI Number Information
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NPI Number | 1710228465
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Entity Type | Individual
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Provider Name | MARK DANZER PT, DPT
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Gender | Male
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Dates
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Enumeration Date | 03/05/2013
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Last Update Date | 03/05/2013
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Provider Practice Location Address
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Address Line | 17010 MATINAL RD
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City | SAN DIEGO
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State | CA
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Zip | 92127-1452
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Country | US
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Telephone | 619-746-3140
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Fax |
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Provider Business Mailing Address
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Address Line | 16885 VIA DEL CAMPO CT SUITE #215
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City | SAN DIEGO
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State | CA
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Zip | 92127-1721
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Country | US
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Telephone |
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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 | 22223
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License Number State | CA
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