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General NPI Number Information
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NPI Number | 1770279630
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Entity Type | Individual
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Provider Name | ELIZA BETH WENDT PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 04/13/2023
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Last Update Date | 04/13/2023
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Provider Practice Location Address
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Address Line | 11750 SORRENTO VALLEY RD STE 130
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City | SAN DIEGO
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State | CA
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Zip | 92121-1019
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Country | US
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Telephone | 858-299-4684
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Fax |
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Provider Business Mailing Address
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Address Line | 1280 HACIENDA DR APT G14
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City | VISTA
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State | CA
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Zip | 92081-6457
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Country | US
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Telephone | 303-981-7701
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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 | 303886
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License Number State | CA
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