Provider Demographics
NPI:1558173393
Name:CONNOR, SEAN (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:SEAN
Middle Name:
Last Name:CONNOR
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:544 SCOTTSBLUFF DR
Mailing Address - Street 2:
Mailing Address - City:CLAREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:91711-2986
Mailing Address - Country:US
Mailing Address - Phone:909-239-9796
Mailing Address - Fax:
Practice Address - Street 1:10590 TOWN CENTER DR STE 100
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-0361
Practice Address - Country:US
Practice Address - Phone:909-948-1124
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-20
Last Update Date:2025-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA3073372251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic