Vital Physical Therapy Inc.

Primary specialty

Cardiopulmonary Physical TherapistTaxonomy code 2251C2600X

License

35986 Issued in CA

Legal business name

VITAL PHYSICAL THERAPY INC.

Practice address

5820 Oberlin Dr Ste 111
San Diego, CA 92121-3743

Phone

(858) 255-7976

Fax

(858) 255-7969

NPI assigned

Nov 15, 2012

Organization subpart

No

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

Authorized official

Name

Komal Deokule

Title

President

Phone

(858) 255-7976

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1352937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534896000000",
    "number": "1174867154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 910883",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921910883",
            "telephone_number": "858-255-7976",
            "fax_number": "858-255-7969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5820 OBERLIN DR STE 111",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921213743",
            "telephone_number": "858-255-7976",
            "fax_number": "858-255-7969"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2555 Camino Del Rio S",
            "address_2": "STE 102",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921083704",
            "country_code": "US",
            "telephone_number": "858-255-7976",
            "fax_number": "858-255-7969",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "VITAL PHYSICAL THERAPY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-15",
        "last_updated": "2018-08-22",
        "status": "A",
        "authorized_official_last_name": "DEOKULE",
        "authorized_official_first_name": "KOMAL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "858-255-7976"
    },
    "taxonomies": [
        {
            "code": "2251C2600X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist, Cardiopulmonary",
            "state": "CA",
            "license": "35986",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Vista
• Evangeline Viste
• Lily Taylor Dancis Vistica
• Vital Care Health Systems
• Vital Fortitude Rehab and Performance
• Kenneth Craig Vitale, M.D.
• Mitchell Taylor Vitale, PHARM.D.
• Vitalhealth Home Care PC
• Vitality Acupuncture
• Vitality Physical Therapy and Wellness

• Physical Therapist in San Diego, CA
• Providers in San Diego, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2018; 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.