Provider Demographics
NPI:1558584342
Name:LUMSDEN, JAMES SCOTT (MPT)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:SCOTT
Last Name:LUMSDEN
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 W HARBOR DR UNIT 203
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92101-7720
Mailing Address - Country:US
Mailing Address - Phone:619-867-1789
Mailing Address - Fax:
Practice Address - Street 1:5353 MISSION CENTER RD STE 221
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-1304
Practice Address - Country:US
Practice Address - Phone:619-497-2836
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23473225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW16522Medicare ID - Type Unspecified