Provider Demographics
NPI:1518955574
Name:MORGAN, TRACI M (PA-C)
Entity Type:Individual
Prefix:
First Name:TRACI
Middle Name:M
Last Name:MORGAN
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:7525 METROPOLITAN DR
Mailing Address - Street 2:SUITE 302
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-4411
Mailing Address - Country:US
Mailing Address - Phone:619-325-1161
Mailing Address - Fax:619-325-1717
Practice Address - Street 1:7525 METROPOLITAN DR
Practice Address - Street 2:SUITE 302
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-4411
Practice Address - Country:US
Practice Address - Phone:619-325-1161
Practice Address - Fax:619-325-1717
Is Sole Proprietor?:No
Enumeration Date:2005-10-12
Last Update Date:2011-10-24
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Provider Licenses
StateLicense IDTaxonomies
CA16226363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical