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General NPI Number Information
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NPI Number | 1801548409
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Entity Type | Organization
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Legal Business Name | SOMA PHYSICAL THERAPY INC
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Dates
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Enumeration Date | 01/25/2022
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Last Update Date | 03/21/2023
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Provider Practice Location Address
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Address Line | 1740 LA COSTA MEADOWS DR STE 250
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City | SAN MARCOS
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State | CA
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Zip | 92078-2122
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Country | US
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Telephone | 760-516-8900
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Fax | 760-410-6175
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Provider Business Mailing Address
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Address Line | 1245 SAN PABLO DR
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City | SAN MARCOS
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State | CA
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Zip | 92078-4816
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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 | OWNER/ PHYSICAL THERAPIST
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Name | DR. ADAM ROBERT PAVLOVICH
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Credential | DPT
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Telephone | 607-341-2479
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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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Taxonomy #2
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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