MEDICARE: MESA PHYSICAL THERAPY

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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	513299	OTHER	CA	FIRST HEALTH

General Provider Information

NPI Number	:	1841258126
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MESA PHYSICAL THERAPY

Provider Business Mailing Address
First Line	:	5962 LA PLACE CT
Second Line	:
City	:	CARLSBAD
State	:	CA
Zip	:	92008-8807
Country	:	US
Telephone Number	:	800-929-4776
Fax Number	:	760-931-8370

Provider Business Practice Location Address
First Line	:	7510 CLAIREMONT MESA BLVD
Second Line	:	#103
City	:	SAN DIEGO
State	:	CA
Zip	:	92111-1539
Country	:	US
Telephone Number	:	858-277-2277
Fax Number	:	858-277-7358

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	ANNE LASSON
Credential	:
Telephone Number	:	408-570-0510

Provider Enumeration Date	:	05/03/2006
Last Update Date	:	09/27/2007

Similar Medicare Providers

1952324766 — DR. JEFFREY MARK SMITH M.D.
Practice Location Address:

7510 CLAIREMONT MESA BLVD STE 100
SAN DIEGO, CA
92111-1539

Practice Phone: 858-278-8031
Practice Fax: 858-278-1708

1700898103 — JEFFREY M. SMITH, M.D., INC.
Practice Location Address:

7510 CLAIREMONT MESA BLVD STE 100
SAN DIEGO, CA
92111-1539

Practice Phone: 858-278-8031
Practice Fax: 888-281-5140

1336225820 — PERRY ROSEN
Practice Location Address:

7510 CLAIREMONT MESA BLVD , SUITE 103
SAN DIEGO, CA
92111-1539

Practice Phone: 858-277-2277
Practice Fax:

1437370442 — MR. PAUL ROMAYOR
Practice Location Address:

7510 CLAIREMONT MESA BLVD. SUITE 103
SAN DIEGO, CA
92111-1539

Practice Phone: 858-277-2277
Practice Fax: 858-277-7358

1710193602 — MR. MARK ADRIAN COSTELLO PT
Practice Location Address:

7510 CLAIREMONT MESA BLVD , SUITE 103
SAN DIEGO, CA
92111-1539

Practice Phone: 858-277-2277
Practice Fax:

1740474238 — DR. HARMEETH SINGH UPPAL MD
Practice Location Address:

7510 CLAIREMONT MESA BLVD STE 100
SAN DIEGO, CA
92111-1539

Practice Phone: 858-278-8031
Practice Fax: 858-281-5140

Directions to “MESA PHYSICAL THERAPY ” Practice Location

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