Healthcare Provider Details

I. General information

NPI: 1962396515
Provider Name (Legal Business Name): MEGAN ROFFERS DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2025
Last Update Date: 06/06/2025
Certification Date: 06/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10625 SCRIPPS RANCH BLVD STE D2
SAN DIEGO CA
92131-1012
US

IV. Provider business mailing address

10625 SCRIPPS RANCH BLVD STE D2
SAN DIEGO CA
92131-1012
US

V. Phone/Fax

Practice location:
  • Phone: 262-308-0283
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081S0010X
TaxonomySports Medicine (Physical Medicine & Rehabilitation) Physician
License Number308084
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: