MR. MICHAEL JOSEPH DISTEFANO PT
NPI 1396732715
Physical Therapist - Orthopedic in San Diego, CA

Q: What is Michael Distefano's NPI number?

The NPI number for Michael Distefano is 1396732715. It was assigned to this individual provider in the NPPES registry on September 30, 2005.

Q: What is Michael Distefano's specialty?

The primary specialty registered for this NPI is Physical Therapist, specializing in Orthopedic, with taxonomy code 2251X0800X.

Q: When was this NPI record last updated?

The NPPES record for Michael Distefano was last updated on November 19, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since September 30, 2005

4650 PALM AVE, SAN DIEGO, CA 92154(619) 662-5277 Get Directions Write a Review

NPPES record last updated: November 19, 2015. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Mr. Michael Joseph Distefano Pt NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. MICHAEL JOSEPH DISTEFANO PT (NPI 1396732715) is an individual orthopedic provider in San Diego, California, licensed in California (41475) and active in the NPI registry since September 2005.

NPPES Registry Identity

NPI1396732715

Entity TypeIndividualMale

Primary Taxonomy2251X0800X

Provider Legal NameMR. MICHAEL JOSEPH DISTEFANOCredential: PT

Location Address4650 PALM AVESan Diego, CA 92154-8404

Mailing Address4650 Palm AveSan Diego, CA 92154-8404 · (619) 662-5277

Phone(619) 662-5277

Sole ProprietorNo

Enumeration DateSeptember 30, 2005

Last NPPES UpdateNovember 19, 2015

✔ NPI 1396732715 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysical Therapist · OrthopedicRespiratory, Developmental, Rehabilitative and Restorative Service Providers

Taxonomy Code2251X0800X

Licenses✔ Licensed in CA · 41475✔ Licensed in NY · 012611

Definition

A licensed physical therapist, including but not limited to an individual who is a Board Certified Specialist in Orthopaedic Physical Therapy, who has demonstrated specialized knowledge and skill in human anatomy and physiology, movement science; pathology/pathophysiology, pain science, medical and surgical considerations, orthopaedic physical therapy theory and practice, and critical inquiry for evidence-based practice.

4650 PALM AVE, San Diego, CA 92154

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Other Identifiers 3

OtherQ88121NY · Bcbs

Medicare PIN07971GNY

OtherANC890NY · Oxford

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

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