MEDICARE: MEGAN VALENZUELA PT, DPT

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	2251P0200X	Pediatric Physical Therapist	36283	CA

General Provider Information

NPI Number	:	1841528742
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEGAN VALENZUELA PT, DPT

Provider Business Mailing Address
First Line	:	6103 WOLFE ST
Second Line	:
City	:	LAKEWOOD
State	:	CA
Zip	:	90713-1614
Country	:	US
Telephone Number	:	562-761-2743
Fax Number	:

Provider Business Practice Location Address
First Line	:	3002 DOW AVE STE 114
Second Line	:
City	:	TUSTIN
State	:	CA
Zip	:	92780-7247
Country	:	US
Telephone Number	:	714-731-4668
Fax Number	:

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

Provider Enumeration Date	:	12/03/2009
Last Update Date	:	02/14/2024

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