Provider Demographics
NPI:1225197114
Name:NORRDIN, DANNY DEMBY (MPT)
Entity type:Individual
Prefix:MR
First Name:DANNY
Middle Name:DEMBY
Last Name:NORRDIN
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 1:6699 ALVARADO RD
Mailing Address - Street 2:SUITE 2100
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92120-5238
Mailing Address - Country:US
Mailing Address - Phone:858-793-7860
Mailing Address - Fax:
Practice Address - Street 1:4010 SORRENTO VALLEY BLVD
Practice Address - Street 2:SUITE 300
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92121-1432
Practice Address - Country:US
Practice Address - Phone:858-793-7876
Practice Address - Fax:858-436-1289
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2011-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT30311225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW12026OtherGROUP PTAN