| Kathleen J. Grace Rpt Apc | |
|
8929 University Center Ln, Ste # 200, San Diego, CA 92122-1006 | |
| (858) 457-3545 | |
| (858) 457-0976 |
| Full Name | Kathleen J. Grace Rpt Apc |
|---|---|
| Type | Facility |
| Speciality | Physician Assistant - Surgical |
| Location | 8929 University Center Ln, San Diego, California |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740201730 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | 9486PT (California) | Secondary |
| 363AS0400X | Physician Assistant - Surgical | 473 (California) | Primary |
| Provider Name | Kathleen J Grace |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1114977980 PECOS PAC ID: 7012909203 Enrollment ID: I20120419000739 |
| Provider Name | Meghan L Burris |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1730444951 PECOS PAC ID: 5799930731 Enrollment ID: I20130225000211 |
| Provider Name | Jayme L Cargnoni |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1164079109 PECOS PAC ID: 3577894880 Enrollment ID: I20191016003481 |
| Provider Name | Maria Sophia Mcmillan |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1104509405 PECOS PAC ID: 3779938881 Enrollment ID: I20231010002169 |
| Mailing Address | Practice Location Address |
|---|---|
| Kathleen J. Grace Rpt Apc 8929 University Center Ln, Ste # 200, San Diego, CA 92122-1006 Ph: (858) 457-3545 | Kathleen J. Grace Rpt Apc 8929 University Center Ln, Ste # 200, San Diego, CA 92122-1006 Ph: (858) 457-3545 |