Provider Demographics
NPI:1881804201
Name:STERNER, GREGORY C (PT,OCS,MDT)
Entity type:Individual
Prefix:
First Name:GREGORY
Middle Name:C
Last Name:STERNER
Suffix:
Gender:M
Credentials:PT,OCS,MDT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2750 DEWEY RD STE 101
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92106-6142
Mailing Address - Country:US
Mailing Address - Phone:619-756-7500
Mailing Address - Fax:
Practice Address - Street 1:2750 DEWEY RD. STE 101
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92106
Practice Address - Country:US
Practice Address - Phone:619-756-7500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2012-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT29374225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist