# VITAL PHYSICAL THERAPY INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1174867154
- **Authorized official:** KOMAL DEOKULE (PRESIDENT)
- **Authorized official phone:** (858) 255-7976

## Contact information

- **Practice address:** 5820 OBERLIN DR STE 111, SAN DIEGO, CA 92121-3743
- **Practice address phone:** (858) 255-7976
- **Practice address fax:** (858) 255-7969
- **Mailing address:** PO BOX 910883, SAN DIEGO, CA 92191-0883
- **Mailing address phone:** (858) 255-7976
- **Mailing address fax:** (858) 255-7969

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2251C2600X | Cardiopulmonary Physical Therapist | 35986 | CA | Yes |

## Other

- **Enumeration date:** 11/15/2012
- **Last updated:** 08/22/2018