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General NPI Number Information
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NPI Number | 1790672954
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Entity Type | Organization
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Legal Business Name | LIVARA HEALTH MEDICAL GROUP PC
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Dates
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Enumeration Date | 06/20/2025
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Last Update Date | 06/20/2025
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Provider Practice Location Address
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Address Line | 6005 HIDDEN VALLEY RD STE 100
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City | CARLSBAD
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State | CA
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Zip | 92011-4223
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Country | US
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Telephone | 844-316-7979
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Fax | 866-813-1235
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Provider Business Mailing Address
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Address Line | 7525 METROPOLITAN DR STE 36
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City | SAN DIEGO
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State | CA
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Zip | 92108-4411
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Country | US
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Telephone | 619-275-7460
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Fax | 866-813-1235
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Authorized Official
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Title or Position | LICENSING & CREDENTIALING SPECIALIS
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Name | VALERIE CUARTAS
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Credential |
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Telephone | 844-316-7979
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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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