Provider Demographics
NPI:1225238132
Name:AMORILLO, MICHAEL SEBASTIAN
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:SEBASTIAN
Last Name:AMORILLO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1621 N VULCAN AVE
Mailing Address - Street 2:
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-1513
Mailing Address - Country:US
Mailing Address - Phone:858-692-7872
Mailing Address - Fax:
Practice Address - Street 1:2530 VISTA WAY STE H
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92054-6174
Practice Address - Country:US
Practice Address - Phone:760-435-9390
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-19
Last Update Date:2007-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA262112251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic