Provider Demographics
NPI:1437383742
Name:BRONSHTEIN, REGINA (MS, RPT)
Entity Type:Individual
Prefix:MRS
First Name:REGINA
Middle Name:
Last Name:BRONSHTEIN
Suffix:
Gender:F
Credentials:MS, RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 502530
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92150-2530
Mailing Address - Country:US
Mailing Address - Phone:858-613-1968
Mailing Address - Fax:858-613-0451
Practice Address - Street 1:12630 MONTE VISTA RD.
Practice Address - Street 2:STE 201A
Practice Address - City:POWAY
Practice Address - State:CA
Practice Address - Zip Code:92064
Practice Address - Country:US
Practice Address - Phone:858-613-1968
Practice Address - Fax:858-613-0451
Is Sole Proprietor?:No
Enumeration Date:2009-05-14
Last Update Date:2009-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23986225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist