MEDICARE: ES3 PHYSICAL THERAPY INC

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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1700478278
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ES3 PHYSICAL THERAPY INC

Provider Business Mailing Address
First Line	:	10425 TIERRASANTA BLVD STE 102
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92124-2618
Country	:	US
Telephone Number	:	858-598-5055
Fax Number	:	858-598-5075

Provider Business Practice Location Address
First Line	:	10425 TIERRASANTA BLVD STE 102
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92124-2618
Country	:	US
Telephone Number	:	858-598-5055
Fax Number	:	858-598-5075

Authorized Official
Title or Position	:	OWNER, CEO, DIRECTOR, PT
Name	:	DR. RENEE STETKEVICH
Credential	:	PT
Telephone Number	:	858-539-3790

Provider Enumeration Date	:	02/06/2021
Last Update Date	:	06/16/2025

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