Provider Demographics
NPI:1780651265
Name:PABISZ, ELIZABETH HELENE (MPT)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:HELENE
Last Name:PABISZ
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:HELENE
Other - Last Name:HIBERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1684 MOUNTAIN PASS CIR
Mailing Address - Street 2:
Mailing Address - City:VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:92081-8811
Mailing Address - Country:US
Mailing Address - Phone:760-518-2384
Mailing Address - Fax:
Practice Address - Street 1:1684 MOUNTAIN PASS CIR
Practice Address - Street 2:
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92081
Practice Address - Country:US
Practice Address - Phone:760-489-1969
Practice Address - Fax:760-489-5226
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-03
Last Update Date:2020-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT15413225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWPT15413BMedicare ID - Type Unspecified