Distefano, Michael Joseph

Distefano, Michael Joseph is an individual health care provider with primary practice located at 4650 Palm Ave , San Diego CA 92154-8404. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthopedic, which is considered as his primary health care specialty. Distefano, Michael Joseph can be contacted via phone (619) 662-5277.

Contact Information

Primary practice address
4650 Palm Ave San Diego CA 92154-8404
Phone: (619) 662-5277
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthopedic 2251X0800X 41475 California
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthopedic 2251X0800X 012611 New York

Profile Details

NPI number 1396732715
LBN Legal business name Distefano, Michael Joseph
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 30th, 2005
Last updated Nov 19th, 2015 - about 11 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 1396732715 NPPES
New York Other Q88121 BCBS
New York Other ANC890 BCBS

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