Provider Demographics
NPI:1528515806
Name:GERBARG PHYSICAL THERAPY, INC.
Entity type:Organization
Organization Name:GERBARG PHYSICAL THERAPY, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVE
Authorized Official - Middle Name:
Authorized Official - Last Name:GERBARG
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:858-848-6639
Mailing Address - Street 1:2586 LUCIERNAGA ST
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92009-5819
Mailing Address - Country:US
Mailing Address - Phone:858-848-6639
Mailing Address - Fax:844-231-8868
Practice Address - Street 1:722 GENEVIEVE ST STE S
Practice Address - Street 2:
Practice Address - City:SOLANA BEACH
Practice Address - State:CA
Practice Address - Zip Code:92075-2061
Practice Address - Country:US
Practice Address - Phone:858-848-6639
Practice Address - Fax:844-231-8868
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-05
Last Update Date:2016-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA39289261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy