Organization
ACTIVERX PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE GUIDO (CLINICAL DIRECTOR)
(858) 705-0505
Entity
Organization
Contact information
Practice address
4765 CARMEL MOUNTAIN RD, SUITE 102, SAN DIEGO, CA 92130-6657
(858) 705-5050
Mailing address
4765 CARMEL MOUNTAIN RD, SUITE 102, SAN DIEGO, CA 92130-6657
(858) 705-5050
Taxonomy
Speciality
Code
Description
License number
State
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
28518
CA
Other
Enumeration date
06/10/2010
Last updated
08/20/2010
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