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General NPI Number Information
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NPI Number | 1942625884
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Entity Type | Organization
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Legal Business Name | DEAN SPORTS CONSULTANTS PHYSICAL THERAPY INC
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Dates
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Enumeration Date | 03/02/2014
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Last Update Date | 11/24/2025
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Provider Practice Location Address
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Address Line | 201 CALLE DE LOS MOLINOS
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City | SAN CLEMENTE
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State | CA
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Zip | 92672-3874
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Country | US
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Telephone | 949-388-5692
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Fax |
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Provider Business Mailing Address
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Address Line | 913 VIA PRESA
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City | SAN CLEMENTE
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State | CA
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Zip | 92672-9489
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Country | US
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Telephone | 949-388-5692
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Fax | 855-414-8993
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Authorized Official
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Title or Position | CEO
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Name | KEVYN KEITH DEAN
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Credential | PT
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Telephone | 949-388-5692
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | PT17708
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License Number State | CA
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