MEDICARE: MR. SEAN WILLIAM KUHN JR. 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
1	225100000X	Physical Therapist	40879	CA

General Provider Information

NPI Number	:	1821429119
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. SEAN WILLIAM KUHN JR. PT, DPT

Provider Business Mailing Address
First Line	:	4876 SANTA MONICA AVE
Second Line	:	# 204
City	:	SAN DIEGO
State	:	CA
Zip	:	92107-2811
Country	:	US
Telephone Number	:	619-578-2880
Fax Number	:	619-578-2880

Provider Business Practice Location Address
First Line	:	4876 SANTA MONICA AVE
Second Line	:	# 204
City	:	SAN DIEGO
State	:	CA
Zip	:	92107-2811
Country	:	US
Telephone Number	:	619-578-2880
Fax Number	:	619-578-2880

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/11/2013
Last Update Date	:	07/03/2019

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