Healthcare Provider Details

I. General information

NPI: 1013848456
Provider Name (Legal Business Name): ANNA GRATALO PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5807 UNIVERSITY AVE STE 6
SAN DIEGO CA
92115-6295
US

IV. Provider business mailing address

1912 MILLENIA AVE APT 303
CHULA VISTA CA
91915-3081
US

V. Phone/Fax

Practice location:
  • Phone: 619-500-1098
  • Fax:
Mailing address:
  • Phone: 208-863-1615
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number310203
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: