Provider Demographics
NPI:1750103511
Name:KNIGHT OSTEOPATHIC HEALING INC
Entity type:Organization
Organization Name:KNIGHT OSTEOPATHIC HEALING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:KNIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:619-964-1321
Mailing Address - Street 1:5815 YOKOHAMA CT
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92120-3964
Mailing Address - Country:US
Mailing Address - Phone:619-964-1321
Mailing Address - Fax:
Practice Address - Street 1:3706 RUFFIN RD
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-1812
Practice Address - Country:US
Practice Address - Phone:619-964-1321
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-31
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMMGroup - Single Specialty