NPIMap

Organization Active NPI

San Diego Spine & Sport, Inc

Doing business as South Bay Spine & Sport

  • Ergonomics Occupational Therapist
  • Chula Vista, CA
National Provider Identifier
1063405637
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ergonomics Occupational TherapistTaxonomy code 225XE1200X
Legal business name
SAN DIEGO SPINE & SPORT, INC
Doing business as
South Bay Spine & Sport
Practice address
450 4TH Ave
#215
Chula Vista, CA 91910-4426
Phone
(619) 585-3745
Fax
(619) 585-3746
NPI assigned
Aug 29, 2005
Last updated
Sep 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Vert Mooney, M.D.
Title
Owner
Phone
(858) 751-0900

Specialties & licenses 10

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X NU
Orthotic Fitter 225000000X NU
Physical Therapist 225100000X NU
Clinical Electrophysiology Physical Therapist 2251E1300X NU
Hand Physical Therapist 2251H1200X NU
Sports Physical Therapist 2251S0007X NU
Physical Therapy Assistant 225200000X NU
Occupational Therapist 225X00000X NU
Ergonomics Occupational Therapist 225XE1200X NU Primary
Hand Occupational Therapist 225XH1200X NU

Addresses

Primary practice location

450 4TH Ave
#215
Chula Vista, CA 91910-4426

Mailing address

450 4TH Ave
#215
Chula Vista, CA 91910-4426
Phone (619) 585-3745

Other names 1

  • SOUTH BAY SPINE & SPORT Doing business as

National Provider Directory

National Provider Directory
Tax ID family
MDRS Spine Sport Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1125273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1063405637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 4TH AVE",
            "address_2": "#215",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919104426",
            "telephone_number": "619-585-3745",
            "fax_number": "619-585-3746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 4TH AVE",
            "address_2": "#215",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919104426",
            "telephone_number": "619-585-3745",
            "fax_number": "619-585-3746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN DIEGO SPINE & SPORT, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-29",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "MOONEY",
        "authorized_official_first_name": "VERT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "858-751-0900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225000000X",
            "taxonomy_group": "",
            "desc": "Orthotic Fitter",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2251E1300X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Electrophysiology, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2251H1200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Hand",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225XE1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Ergonomics",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SOUTH BAY SPINE & SPORT",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chula Vista, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.