Provider Demographics
NPI:1770929168
Name:LAMBE, BRIAN (MPT)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:
Last Name:LAMBE
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:836 W PENNSYLVANIA AVE
Mailing Address - Street 2:UNIT 111
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-3849
Mailing Address - Country:US
Mailing Address - Phone:619-417-5362
Mailing Address - Fax:
Practice Address - Street 1:2355 NORTHSIDE DR
Practice Address - Street 2:SUITE 100
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-2705
Practice Address - Country:US
Practice Address - Phone:858-436-5300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-13
Last Update Date:2013-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA28330225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist