Regenerate Physical Therapy and Performance

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

REGENERATE PHYSICAL THERAPY AND PERFORMANCE

Practice address

13337 Tining Dr
Poway, CA 92064-1220

Phone

(920) 941-0136

NPI assigned

May 2, 2023

Organization subpart

No

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

Authorized official

Name

Daniel MortimerNPI 1316447279

Title

Ceo/Owner

Phone

(920) 941-0136

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Daniel Mortimer

  • Physical Therapist
  • San Diego, CA
  • NPI 1316447279
  NPD Authorized official

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

{
    "created_epoch": "1682985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682985600000",
    "number": "1437848967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 21ST ST STE R",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958115226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13337 TINING DR",
            "city": "POWAY",
            "state": "CA",
            "postal_code": "920641220",
            "telephone_number": "920-941-0136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGENERATE PHYSICAL THERAPY AND PERFORMANCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-02",
        "last_updated": "2023-05-02",
        "certification_date": "2023-05-02",
        "status": "A",
        "authorized_official_last_name": "MORTIMER",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "920-941-0136"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Galya Raz, D.M.D.
• Jenny Raz, LCSW
• Reid Recendiz
• Dillon Redd
• Smitha Reddy, M.D.
• Rohan C Reid II
• Madeline Reid
• Dennis Reilly
• Alison Reints
• Remote Diagnostic Interpreters PC

• Physical Therapy Clinic/Center in Poway, CA
• Providers in Poway, CA by specialty
• Physical Therapy Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 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.