MEDICARE: SELECT SAN DIEGO PHYSICAL THERAPY, PC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2000X	Physical Therapy Clinic/Center

General Provider Information

NPI Number	:	1346970043
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SELECT SAN DIEGO PHYSICAL THERAPY, PC.

Provider Business Mailing Address
First Line	:	4714 GETTYSBURG RD
Second Line	:
City	:	MECHANICSBURG
State	:	PA
Zip	:	17055-4325
Country	:	US
Telephone Number	:	717-972-1100
Fax Number	:

Provider Business Practice Location Address
First Line	:	4910 DIRECTORS PL STE 370
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92121-3814
Country	:	US
Telephone Number	:	858-554-0522
Fax Number	:	858-554-0536

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	ALLEN CARPENTER
Credential	:
Telephone Number	:	717-972-1100

Provider Enumeration Date	:	06/15/2022
Last Update Date	:	06/20/2023

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