Organization
SAN DIEGO SPINE & SPORT, INC
Active
Organization
SAN DIEGO SPINE & SPORT, INC
Active
Other names
SOUTH BAY SPINE & SPORT
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VERT MOONEY M.D. (OWNER)
(858) 751-0900
Entity
Organization
Contact information
Practice address
450 4TH AVE, #215, CHULA VISTA, CA 91910-4426
(619) 585-3745
(619) 585-3746
Mailing address
450 4TH AVE, #215, CHULA VISTA, CA 91910-4426
(619) 585-3745
(619) 585-3746
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
—
—
225000000X
Orthotic Fitter
—
—
225100000X
Physical Therapist
—
—
2251E1300X
Clinical Electrophysiology Physical Therapist
—
—
2251H1200X
Hand Physical Therapist
—
—
2251S0007X
Sports Physical Therapist
—
—
225200000X
Physical Therapy Assistant
—
—
225X00000X
Occupational Therapist
—
—
225XE1200X
Ergonomics Occupational Therapist
Primary
—
—
225XH1200X
Hand Occupational Therapist
—
—
Other
Enumeration date
08/29/2005
Last updated
09/11/2025
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