NPIMap

Organization Active NPI

Downtown Water and Sports

  • Physical Therapist
  • Coronado, CA
National Provider Identifier
1346316270
Registry record updated Oct 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
DOWNTOWN WATER AND SPORTS
Practice address
120 C Ave
Coronado, CA 92118-1979
Phone
(858) 488-3597
Fax
(858) 488-3178
NPI assigned
Nov 24, 2006
Last updated
Oct 31, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2023

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

Authorized official

Name
Kahl Goldfarb, PTNPI 1871669622
Title
Owner
Phone
(858) 488-3597

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT20904 CA
Physical Therapist 225100000X PT23900 CA
Physical Therapist 225100000X PT27239 CA
Physical Therapist 225100000X NU Primary
Massage Therapist 225700000X CA

Addresses

Primary practice location

120 C Ave
Coronado, CA 92118-1979

Mailing address

3639 Midway Dr Ste B286
San Diego, CA 92110-5254
Phone (858) 488-3597

Other names 1

  • Water & Sports Physical Therapy, Inc. Other name

National Provider Directory

National Provider Directory

Locations

3639 Midway Dr
Ste B286
San Diego, CA 92110
Phone (858) 724-1747

Practitioners & affiliated clinicians

Practitioners 3

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": "1164326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698710400000",
    "number": "1346316270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3639 MIDWAY DR STE B286",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921105254",
            "telephone_number": "858-488-3597",
            "fax_number": "858-488-3178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 C AVE",
            "city": "CORONADO",
            "state": "CA",
            "postal_code": "921181979",
            "telephone_number": "858-488-3597",
            "fax_number": "858-488-3178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOWNTOWN WATER AND SPORTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-24",
        "last_updated": "2023-10-31",
        "certification_date": "2023-10-31",
        "status": "A",
        "authorized_official_last_name": "GOLDFARB",
        "authorized_official_first_name": "KAHL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "858-488-3597",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT20904",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT23900",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT27239",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "CA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Water & Sports Physical Therapy, Inc.",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Water & Sports Physical Therapy, Inc.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Coronado, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2023; 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.