Provider Demographics
NPI:1518119890
Name:THOMANN, LEA L (DPT, ATC, EMT, CSCS)
Entity Type:Individual
Prefix:
First Name:LEA
Middle Name:L
Last Name:THOMANN
Suffix:
Gender:F
Credentials:DPT, ATC, EMT, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1042 N EL CAMINO REAL
Mailing Address - Street 2:# B-351
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-1322
Mailing Address - Country:US
Mailing Address - Phone:760-918-9200
Mailing Address - Fax:760-918-9203
Practice Address - Street 1:3959 RUFFIN RD
Practice Address - Street 2:SUITE F
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-1830
Practice Address - Country:US
Practice Address - Phone:858-279-5570
Practice Address - Fax:858-279-5303
Is Sole Proprietor?:No
Enumeration Date:2008-10-17
Last Update Date:2016-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA34852OtherPT LICENSE