Provider Demographics
NPI:1790382422
Name:PACZKOWSKI PHYSICAL THERAPY, APC
Entity Type:Organization
Organization Name:PACZKOWSKI PHYSICAL THERAPY, APC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:LINDSEY
Authorized Official - Middle Name:
Authorized Official - Last Name:PACZKOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:760-301-6566
Mailing Address - Street 1:6884 EMBARCADERO LN
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92011-3227
Mailing Address - Country:US
Mailing Address - Phone:760-301-6566
Mailing Address - Fax:
Practice Address - Street 1:6884 EMBARCADERO LN
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92011-3227
Practice Address - Country:US
Practice Address - Phone:760-301-6566
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-06
Last Update Date:2020-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA291527OtherPRIVATE PRACTICE
CA291980OtherPRIVATE PRACTICE
1457755860OtherPRIVATE PRACTICE