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NPI Code Detail

MEDICARE: ROBERT W KILLEBREW DPT

MEDICARE:   ROBERT W KILLEBREW  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
12081S0010XSports Medicine (Physical Medicine & Rehabilitation) Physician1277699TX
2225100000XPhysical Therapist301735CA

General Provider Information

NPI Number : 1700380763
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROBERT W KILLEBREW DPT
Provider Business Mailing Address
First Line : 7525 METROPOLITAN DR STE 306
Second Line :
City : SAN DIEGO
State : CA
Zip : 92108-4404
Country : US
Telephone Number : 844-316-7979
Fax Number : 866-813-1235
Provider Business Practice Location Address
First Line : 1828 OCEANSIDE BLVD
Second Line :
City : OCEANSIDE
State : CA
Zip : 92054-3452
Country : US
Telephone Number : 844-316-7979
Fax Number : 866-813-1235
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/22/2018
Last Update Date : 10/08/2024

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Directions to “ ROBERT W KILLEBREW DPT” Practice Location

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