MEDICARE: MRS. MEGAN LYNN ROSENSTOCK MPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2251P0200X	Pediatric Physical Therapist	PT27165	CA

General Provider Information

NPI Number	:	1407106479
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MEGAN LYNN ROSENSTOCK MPT

Provider Business Mailing Address
First Line	:	2091 HEIGHTS CT
Second Line	:
City	:	ESCONDIDO
State	:	CA
Zip	:	92027-4751
Country	:	US
Telephone Number	:	760-271-9634
Fax Number	:

Provider Business Practice Location Address
First Line	:	2091 HEIGHTS CT
Second Line	:
City	:	ESCONDIDO
State	:	CA
Zip	:	92027-4751
Country	:	US
Telephone Number	:	760-271-9634
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/17/2012
Last Update Date	:	09/17/2012

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