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NPI Code Detail

MEDICARE: BROOKE CARAGATA

MEDICARE: BROOKE CARAGATA
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 Therapist305543CA

General Provider Information

NPI Number : 1912761404
Entity Type Code : Individual
Provider Name (Legal Business Name) : BROOKE CARAGATA
Provider Business Mailing Address
First Line : 851 AGATE ST
Second Line :
City : SAN DIEGO
State : CA
Zip : 92109-1174
Country : US
Telephone Number : 928-388-9897
Fax Number :
Provider Business Practice Location Address
First Line : 4010 MORENA BLVD STE 103
Second Line :
City : SAN DIEGO
State : CA
Zip : 92117-4547
Country : US
Telephone Number : 619-356-1315
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/06/2024
Last Update Date : 07/25/2025

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Directions to “ BROOKE CARAGATA ” Practice Location

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