Provider Demographics
NPI:1023202603
Name:KOMAR, LYNN ELIZABETH (MSPT)
Entity Type:Individual
Prefix:MRS
First Name:LYNN
Middle Name:ELIZABETH
Last Name:KOMAR
Suffix:
Gender:F
Credentials:MSPT
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Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3666 KEARNY VILLA RD STE 200
Mailing Address - Street 2:SHARP REES STEALY PHYSICAL THERAPY
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-1951
Mailing Address - Country:US
Mailing Address - Phone:858-505-5400
Mailing Address - Fax:858-505-5459
Practice Address - Street 1:3666 KEARNY VILLA RD
Practice Address - Street 2:SUITE 200
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-1951
Practice Address - Country:US
Practice Address - Phone:858-505-5400
Practice Address - Fax:858-505-5459
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-28
Last Update Date:2007-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT18531225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist