Provider Demographics
NPI:1053093773
Name:BAILEY, DYLAN J (DPT)
Entity type:Individual
Prefix:
First Name:DYLAN
Middle Name:J
Last Name:BAILEY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1909 CARENNAC PL APT 55
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91913-5030
Mailing Address - Country:US
Mailing Address - Phone:619-392-6758
Mailing Address - Fax:
Practice Address - Street 1:585 SATURN BLVD STE A
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92154-4721
Practice Address - Country:US
Practice Address - Phone:619-591-1190
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-02
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist