MEDICARE: MEGAN GRAFF SUAREZ

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	293005	CA

General Provider Information

NPI Number	:	1922498138
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEGAN GRAFF SUAREZ

Provider Business Mailing Address
First Line	:	3267 OCEAN FRONT WALK
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92109-7773
Country	:	US
Telephone Number	:	713-870-8830
Fax Number	:

Provider Business Practice Location Address
First Line	:	5745 KEARNY VILLA RD
Second Line	:	STE 113
City	:	SAN DIEGO
State	:	CA
Zip	:	92123-1171
Country	:	US
Telephone Number	:	619-210-0945
Fax Number	:

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

Provider Enumeration Date	:	01/26/2015
Last Update Date	:	02/27/2025

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