Provider Demographics
NPI:1164835278
Name:GURNEY, ROBERT ANDERSON (PTA)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:ANDERSON
Last Name:GURNEY
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 GLOVER AVE
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91910-2606
Mailing Address - Country:US
Mailing Address - Phone:619-261-9060
Mailing Address - Fax:
Practice Address - Street 1:2355 NORTHSIDE DR
Practice Address - Street 2:SUITE 100
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-2705
Practice Address - Country:US
Practice Address - Phone:858-436-5300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-05
Last Update Date:2014-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10118225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant