San Diego Sports Physical Therapy, PC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

SAN DIEGO SPORTS PHYSICAL THERAPY, PC

Practice address

8290 Vickers St Ste C&D
San Diego, CA 92111-2116

Phone

(619) 510-5000

NPI assigned

Sep 24, 2025

Last updated

Sep 24, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Derek Rustich, PT, DPTNPI 1972224673

Title

Ceo

Phone

(619) 510-5000

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• Derek Scott Rustich, DPT

  • Physical Therapist
  • San Diego, CA
  • NPI 1972224673
  NPD Authorized official

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

{
    "created_epoch": "1758672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758672000000",
    "number": "1295608420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1412 PRIMROSE DR",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "920205644",
            "telephone_number": "619-510-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8290 VICKERS ST STE C&D",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921112116",
            "telephone_number": "619-510-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8380 Center Dr Ste C",
            "address_purpose": "LOCATION",
            "city": "LA Mesa",
            "state": "CA",
            "postal_code": "919422952",
            "country_code": "US",
            "telephone_number": "619-510-5000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "13220 Evening Creek Dr S Ste 109",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921284103",
            "country_code": "US",
            "telephone_number": "619-510-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SAN DIEGO SPORTS PHYSICAL THERAPY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-24",
        "last_updated": "2025-09-24",
        "certification_date": "2025-09-24",
        "status": "A",
        "authorized_official_last_name": "RUSTICH",
        "authorized_official_first_name": "DEREK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "619-510-5000",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• San Diego Spine Center, AMC
• San Diego Sports Acupuncture, Inc
• San Diego Sports and Minimally Invasive Surgery Center LLC (SMI Surgery Center)
• San Diego Sports Medicine & Orthopaedic Center
• San Diego Sports Medicine & Orthopaedic Center Inc.
• San Diego State University
• San Diego State University
• San Diego State University - Healthy Early Years Clinic
• San Diego State University Center for Autism and Developmental Disorders
• San Diego State University Student Health Services

• 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 Sep 24, 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.