Basic Information
| Provider Information | |||||||||
| NPI: | 1013966985 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | GASPAR PHYSICAL THERAPY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7760 EL CAMINO REAL | ||||||||
| Address2: | |||||||||
| City: | CARLSBAD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 920098553 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7606349750 | ||||||||
| FaxNumber: | 7606349752 | ||||||||
| Practice Location | |||||||||
| Address1: | 7760 EL CAMINO REAL | ||||||||
| Address2: | |||||||||
| City: | CARLSBAD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 920098553 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7606349750 | ||||||||
| FaxNumber: | 7606349752 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/09/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | GASPAR | ||||||||
| AuthorizedOfficialFirstName: | PAUL | ||||||||
| AuthorizedOfficialMiddleName: | DAVID | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT/ | ||||||||
| AuthorizedOfficialTelephone: | 7606349750 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | DPT | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | Y | 193400000X SINGLE SPECIALTY GROUP | Other Service Providers | Specialist |
No ID Information.