Provider Demographics
NPI:1679020101
Name:KUNDE, MICHELE AMELIE (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:MICHELE
Middle Name:AMELIE
Last Name:KUNDE
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3134 COWLEY WAY APT 3
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92117-6562
Mailing Address - Country:US
Mailing Address - Phone:805-215-9265
Mailing Address - Fax:
Practice Address - Street 1:10760 THORNMINT RD
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92127-2700
Practice Address - Country:US
Practice Address - Phone:855-426-5437
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-01
Last Update Date:2022-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA291916225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist