Van Dyke, Jason P

Van Dyke, Jason P is an individual health care provider with primary practice located at 215 S Hickory St Ste 224, Escondido CA 92025-4393. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as his primary health care specialty. Van Dyke, Jason P can be contacted via phone (760) 839-2905.

Contact Information

Primary practice address
215 S Hickory St Ste 224 Escondido CA 92025-4393
Phone: (760) 839-2905
Fax: (760) 839-2901
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X PT 25655 California

Profile Details

NPI number 1487658720
LBN Legal business name Van Dyke, Jason P
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 1st, 2005
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1487658720 NPPES
California Other OPT251550 BLUE SHIELD

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