# LIFESPAN PHYSIOTHERAPY STAFFING, INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Lifespan Physical Therapy Services
- **Organization subpart:** No

## Provider details

- **NPI number:** 1578795688
- **Authorized official:** MR. ARMIN SHAVERDIAN (PRESIDENT)
- **Authorized official phone:** (858) 412-9349

## Contact information

- **Practice address:** 2941 4TH AVE, SAN DIEGO, CA 92103
- **Practice address phone:** (619) 888-5838
- **Practice address fax:** (619) 568-3313
- **Mailing address:** 2941 4TH AVE, SAN DIEGO, CA 92103-5901
- **Mailing address phone:** (619) 888-5838
- **Mailing address fax:** (619) 568-3313

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 174400000X | Specialist | PT34535 | CA | — |
| 225X00000X | Occupational Therapist | — | NULL | — |
| 225X00000X | Occupational Therapist | — | — | — |
| 251E00000X | Home Health Agency | — | NULL | Yes |
| 261QP2000X | Physical Therapy Clinic/Center | PT34535 | CA | — |

## Other

- **Enumeration date:** 08/24/2009
- **Last updated:** 04/11/2023