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NPI Code Detail

MEDICARE: EGGLETON & LANGTON PHYSICAL THERAPY MANAGEMENT SERVICES

MEDICARE: EGGLETON & LANGTON PHYSICAL THERAPY MANAGEMENT SERVICES
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
1225100000XPhysical Therapist

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1ZZZ05343ZOTHERCABLUE SHIELD

General Provider Information

NPI Number : 1770520496
Entity Type Code : Organization
Provider Name (Legal Business Name) : EGGLETON & LANGTON PHYSICAL THERAPY MANAGEMENT SERVICES
Provider Business Mailing Address
First Line : 5905 SEVERIN DR
Second Line :
City : LA MESA
State : CA
Zip : 91942-3806
Country : US
Telephone Number : 619-589-2606
Fax Number : 619-464-0900
Provider Business Practice Location Address
First Line : 15373 INNOVATION DR STE 220
Second Line :
City : SAN DIEGO
State : CA
Zip : 92128-3425
Country : US
Telephone Number : 858-592-8855
Fax Number : 858-592-8858
Authorized Official
Title or Position : AUTHORIZED OFFICIAL
Name : ROB PACE
Credential :
Telephone Number : 760-268-7500
Provider Enumeration Date : 06/01/2006
Last Update Date : 05/07/2020

Similar Medicare Providers

1184966764 — MRS. SHANNON RANAE HERMAN LMFT
Practice Location Address:
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SAN DIEGO, CA
92128-3425
Practice Phone: 760-560-7028
Practice Fax:
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Practice Location Address:
15373 INNOVATION DR STE 200
SAN DIEGO, CA
92128-3425
Practice Phone: 858-699-7579
Practice Fax:
1285080382 — ELIZABETH SARTO HOWARTH PHD, BCBA-D
Practice Location Address:
15373 INNOVATION DR STE 200
SAN DIEGO, CA
92128-3425
Practice Phone: 858-699-7579
Practice Fax:
1356890750 — KATRINA SCHLEPP
Practice Location Address:
15373 INNOVATION DR STE 200
SAN DIEGO, CA
92128-3425
Practice Phone: 858-699-7579
Practice Fax:
1386193795 — ALEJANDRO MONTES
Practice Location Address:
15373 INNOVATION DR STE 200
SAN DIEGO, CA
92128-3425
Practice Phone: 858-699-7579
Practice Fax:
1225587520 — TANIA MELISSA LOPEZ
Practice Location Address:
15373 INNOVATION DR STE 200
SAN DIEGO, CA
92128-3425
Practice Phone: 858-699-7579
Practice Fax:

Directions to “EGGLETON & LANGTON PHYSICAL THERAPY MANAGEMENT SERVICES ” Practice Location

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