Individual
MS. MARY LYDIA ENGLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT, MS, OCS
Contact information
Practice address
4120 W POINT LOMA BLVD, SAN DIEGO, CA 92110-5605
(619) 226-4131
(619) 226-4124
Mailing address
4120 W POINT LOMA BLVD, SAN DIEGO, CA 92110-5605
(619) 226-4131
(619) 226-4124
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
PT6252
CA
2251S0007X
Sports Physical Therapist
PT6252
CA
2251X0800X
Orthopedic Physical Therapist
Primary
PT6252
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00PT6252
—
CA
01
—
00PT62520
BLUE CROSS PIN NUMBER
CA
01
—
070112
HEALTH NET PIN NUMBER
CA
Enumeration date
04/17/2006
Last updated
08/05/2010
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