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NPI Code Detail

MEDICARE: JOSHUA OSTROM PT, DPT

MEDICARE: JOSHUA OSTROM PT, DPT
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 TherapistCA

General Provider Information

NPI Number : 1639622442
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSHUA OSTROM PT, DPT
Provider Business Mailing Address
First Line : 4435 EASTGATE MALL
Second Line : #120
City : SAN DIEGO
State : CA
Zip : 92121-1982
Country : US
Telephone Number : 858-587-8669
Fax Number : 858-587-8675
Provider Business Practice Location Address
First Line : 4435 EASTGATE MALL
Second Line : #120
City : SAN DIEGO
State : CA
Zip : 92121-1982
Country : US
Telephone Number : 858-587-8669
Fax Number : 858-587-8675
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/28/2016
Last Update Date : 07/28/2016

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Directions to “ JOSHUA OSTROM PT, DPT” Practice Location

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