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NPI Code Detail

MEDICARE: DENISE O'HAGAN P.T.

MEDICARE: DENISE O'HAGAN P.T.
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
1225100000XPhysical TherapistPT 27066CA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1W12026OTHERCAGROUP MEDICARE

General Provider Information

NPI Number : 1700019262
Entity Type Code : Individual
Provider Name (Legal Business Name) : DENISE O'HAGAN P.T.
Provider Business Mailing Address
First Line : 6699 ALVARADO RD
Second Line : SUITE 2100
City : SAN DIEGO
State : CA
Zip : 92120-5238
Country : US
Telephone Number : 619-229-3929
Fax Number : 619-229-3902
Provider Business Practice Location Address
First Line : 1945 GARNET AVE
Second Line :
City : SAN DIEGO
State : CA
Zip : 92109-3595
Country : US
Telephone Number : 858-224-7977
Fax Number : 858-224-7978
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/01/2009
Last Update Date : 11/14/2018

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Directions to “ DENISE O'HAGAN P.T.” Practice Location

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