MEDICARE: KAREN ABALAJON SILVA QUANBECK PT

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
1	225100000X	Physical Therapist	42978	CA

General Provider Information

NPI Number	:	1285101089
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAREN ABALAJON SILVA QUANBECK PT

Provider Business Mailing Address
First Line	:	4659 OREGON ST
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92116-4921
Country	:	US
Telephone Number	:	530-806-9126
Fax Number	:

Provider Business Practice Location Address
First Line	:	4659 OREGON ST
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92116-4921
Country	:	US
Telephone Number	:	530-806-9126
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/30/2018
Last Update Date	:	10/30/2018

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