| Doctor Name: | KEVIN ROBERT BRESNAHAN |
| NPI Number: | 1043295124 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PT |
| License Number: | PT 14228 |
| Business Practice Address: | 10225 Austin Drive # 204 Spring Valley, CA - 91978 |
| Business Phone Number: | 6196704567 |
| Business Fax Number: | 6196700200 |
| Mailing Address: | 317 N El Camino Real, #210 ENCINITAS |
| State: | CA |
| Postal Code: | 920242811 |
| Phone Number: | 7606340248 |
| Fax Number: | 7606341782 |
| NPI Enumeration Date: | 12/12/2005 |
| NPI Last Update Date: | 04/20/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | PT 14228 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |