Basic Information
| Provider Information | |||||||||
| NPI: | 1679643936 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SIMMONS | ||||||||
| FirstName: | THOMAS | ||||||||
| MiddleName: | CURTIS | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | R.P.T. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 285 N EL CAMINO REAL | ||||||||
| Address2: | STE 202 | ||||||||
| City: | ENCINITAS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 920245383 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7606331345 | ||||||||
| FaxNumber: | 7606331419 | ||||||||
| Practice Location | |||||||||
| Address1: | 201 S EL CAMINO REAL STE A | ||||||||
| Address2: | |||||||||
| City: | ENCINITAS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 920244150 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7602741671 | ||||||||
| FaxNumber: | 7602741678 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/08/2006 | ||||||||
| LastUpdateDate: | 09/18/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | PT11587 | CA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
ID Information
| ID | Type | State | Issuer | Description | PT11587 | 01 | CA | RPT LICENSE | OTHER | 1578547410 | 01 | CA | NPI FOR CORPORATION | OTHER |