Provider Demographics
NPI:1386851467
Name:GASPAR PHYSICAL THERAPY, APC
Entity Type:Organization
Organization Name:GASPAR PHYSICAL THERAPY, APC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:GASPAR
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:760-634-9750
Mailing Address - Street 1:1011 DEVONSHIRE DR STE F
Mailing Address - Street 2:
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-5136
Mailing Address - Country:US
Mailing Address - Phone:760-635-0045
Mailing Address - Fax:760-634-9752
Practice Address - Street 1:1011 DEVONSHIRE DR STE F
Practice Address - Street 2:
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-5136
Practice Address - Country:US
Practice Address - Phone:760-635-0045
Practice Address - Fax:760-634-9752
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW14625Medicare ID - Type Unspecified