Healthcare Provider Details

I. General information

NPI: 1326022435
Provider Name (Legal Business Name): MARIA ELENA MEJIA-O'NEILL PT MPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARIA ELENA MEJIA PT MPT

II. Dates (important events)

Enumeration Date: 12/01/2005
Last Update Date: 03/21/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1922 HACIENDA DR
VISTA CA
92081-6024
US

IV. Provider business mailing address

6987 BLUE ORCHID LN
CARLSBAD CA
92011-5164
US

V. Phone/Fax

Practice location:
  • Phone: 760-295-4175
  • Fax: 760-295-4176
Mailing address:
  • Phone: 760-390-5049
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number8430
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: