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NPI Code Detail

MEDICARE: BONNIE MONTALI HAUPT P.T.

MEDICARE: BONNIE MONTALI HAUPT P.T.
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
1225100000XPhysical TherapistPT14926CA

General Provider Information

NPI Number : 1437244779
Entity Type Code : Individual
Provider Name (Legal Business Name) : BONNIE MONTALI HAUPT P.T.
Provider Business Mailing Address
First Line : 9070 ROTHERHAM AVE
Second Line :
City : SAN DIEGO
State : CA
Zip : 92129-3125
Country : US
Telephone Number : 858-538-6555
Fax Number :
Provider Business Practice Location Address
First Line : 11665 AVENA PL
Second Line : SUITE 106
City : SAN DIEGO
State : CA
Zip : 92128-2421
Country : US
Telephone Number : 858-673-5437
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/03/2006
Last Update Date : 07/08/2007

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