Provider Demographics
NPI:1437658390
Name:SAYLOR HARGUESS, DESIREE MARIE (DPT)
Entity Type:Individual
Prefix:MRS
First Name:DESIREE
Middle Name:MARIE
Last Name:SAYLOR HARGUESS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:DESIREE
Other - Middle Name:
Other - Last Name:HARGUESS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DPT
Mailing Address - Street 1:3145 ROSECRANS ST STE F
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92110-4831
Mailing Address - Country:US
Mailing Address - Phone:619-223-7175
Mailing Address - Fax:619-223-7030
Practice Address - Street 1:3450 BONITA RD STE 105
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91910-3249
Practice Address - Country:US
Practice Address - Phone:619-425-1084
Practice Address - Fax:619-425-1084
Is Sole Proprietor?:No
Enumeration Date:2018-02-06
Last Update Date:2018-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT294140208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPT294140OtherSTATE LICENSE