Provider Demographics
NPI:1598118077
Name:HAMMOND, ANDREW W (PT, DPT, OCS)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:W
Last Name:HAMMOND
Suffix:
Gender:M
Credentials:PT, DPT, OCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:968 SEA CLIFF DR
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92011-1141
Mailing Address - Country:US
Mailing Address - Phone:619-777-6049
Mailing Address - Fax:
Practice Address - Street 1:968 SEA CLIFF DR
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92011-1141
Practice Address - Country:US
Practice Address - Phone:619-777-6049
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-19
Last Update Date:2021-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA297906225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist