Provider Demographics
NPI:1568612018
Name:YARRIS, ROBERT P ETER (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:P ETER
Last Name:YARRIS
Suffix:
Gender:M
Credentials:PHYSICAL THERAPIST
Other - Prefix:MR
Other - First Name:BOB
Other - Middle Name:PETER
Other - Last Name:YARRIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHYSICAL THERAPIST
Mailing Address - Street 1:5480 MARENGO AVE.
Mailing Address - Street 2:
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91942-6932
Mailing Address - Country:US
Mailing Address - Phone:619-660-6687
Mailing Address - Fax:619-660-1497
Practice Address - Street 1:5480 MARENGO AVE
Practice Address - Street 2:
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91942-2408
Practice Address - Country:US
Practice Address - Phone:619-660-6687
Practice Address - Fax:619-660-1497
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-21
Last Update Date:2008-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT6423225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist