Provider Demographics
NPI:1679822522
Name:GERBARG, DAVID S (PT, DPT)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:S
Last Name:GERBARG
Suffix:
Gender:M
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 1:2586 LUCIERNAGA ST
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92009-5819
Mailing Address - Country:US
Mailing Address - Phone:602-743-4739
Mailing Address - Fax:844-231-8868
Practice Address - Street 1:722 GENEVIEVE ST
Practice Address - Street 2:SUITE S
Practice Address - City:SOLANA BEACH
Practice Address - State:CA
Practice Address - Zip Code:92075-2061
Practice Address - Country:US
Practice Address - Phone:858-848-6639
Practice Address - Fax:844-231-8868
Is Sole Proprietor?:No
Enumeration Date:2012-09-06
Last Update Date:2017-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 39289225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist