Provider Demographics
NPI:1992269708
Name:SELMA UMAR
Entity type:Organization
Organization Name:SELMA UMAR
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SELMA
Authorized Official - Middle Name:
Authorized Official - Last Name:UMAR
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:619-717-1406
Mailing Address - Street 1:3555 KENYON ST STE 100
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92110-5341
Mailing Address - Country:US
Mailing Address - Phone:619-717-1406
Mailing Address - Fax:888-557-2908
Practice Address - Street 1:3555 KENYON ST STE 100
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92110-5341
Practice Address - Country:US
Practice Address - Phone:619-717-1406
Practice Address - Fax:888-557-2908
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-25
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty