MEDICARE: CHR PHYSICAL THERAPY

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	2251G0304X	Geriatric Physical Therapist
2	251E00000X	Home Health Agency
3	225100000X	Physical Therapist
4	2251C2600X	Cardiopulmonary Physical Therapist
5	2251N0400X	Neurology Physical Therapist

General Provider Information

NPI Number	:	1588282594
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHR PHYSICAL THERAPY

Provider Business Mailing Address
First Line	:	2127 OLYMPIC PKWY # 1006-602
Second Line	:
City	:	CHULA VISTA
State	:	CA
Zip	:	91915-1359
Country	:	US
Telephone Number	:	619-306-1744
Fax Number	:

Provider Business Practice Location Address
First Line	:	2694 ESCALA CIR
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92108-6720
Country	:	US
Telephone Number	:	619-306-1744
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MARIA FERNANDA PENUNURI
Credential	:	DPT
Telephone Number	:	619-306-1744

Provider Enumeration Date	:	07/07/2020
Last Update Date	:	07/16/2020

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Directions to “CHR PHYSICAL THERAPY ” Practice Location

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