NPIMap

Organization Active NPI

Water and Sports Physical Therapy

  • Physical Medicine & Rehabilitation Physician
  • San Diego, CA
National Provider Identifier
1588085625
Registry record updated Dec 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
PT40754 Issued in CA
Legal business name
WATER AND SPORTS PHYSICAL THERAPY
Practice address
3639 Midway Dr
B286
San Diego, CA 92110-5254
Phone
(858) 488-3597
Fax
(858) 724-1747
NPI assigned
Dec 16, 2013
Last updated
Dec 16, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2013

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

Authorized official

Name
Sophia Hamilton
Title
Office Manager
Phone
(858) 726-2624

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X PT40754 CA Primary

Addresses

Primary practice location

3639 Midway Dr
B286
San Diego, CA 92110-5254

Mailing address

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

National Provider Directory

National Provider Directory
Tax ID family
Water and Sports Physical Therapy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

3639 Midway Dr
#B286
San Diego, CA 92110

Practitioners & affiliated clinicians

Practitioners 78

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.

View all 78

NPI Registry JSON

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

{
    "created_epoch": "1387152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1387152000000",
    "number": "1588085625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3639 MIDWAY DR",
            "address_2": "B286",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921105254",
            "telephone_number": "858-488-3597",
            "fax_number": "858-724-1747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3639 MIDWAY DR",
            "address_2": "B286",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921105254",
            "telephone_number": "858-488-3597",
            "fax_number": "858-724-1747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATER AND SPORTS PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-16",
        "last_updated": "2013-12-16",
        "status": "A",
        "authorized_official_last_name": "HAMILTON",
        "authorized_official_first_name": "SOPHIA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "858-726-2624"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CA",
            "license": "PT40754",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2013; 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.