Healthcare Provider Details

I. General information

NPI: 1598275380
Provider Name (Legal Business Name): MEGAN MORLEY DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2017
Last Update Date: 10/05/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1810 GATEWAY DR STE 110
SAN MATEO CA
94404-2470
US

IV. Provider business mailing address

1810 GATEWAY DR STE 110
SAN MATEO CA
94404-2470
US

V. Phone/Fax

Practice location:
  • Phone: 650-345-2739
  • Fax: 650-345-2756
Mailing address:
  • Phone: 650-345-2739
  • Fax: 650-345-2756

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number293780
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: