Provider Demographics
NPI:1255608618
Name:MCDONALD, MEGAN CHRISTINE (DPT)
Entity type:Individual
Prefix:MS
First Name:MEGAN
Middle Name:CHRISTINE
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:526 ANDERSON PL APT 15
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-4225
Mailing Address - Country:US
Mailing Address - Phone:818-518-8535
Mailing Address - Fax:
Practice Address - Street 1:1609 E MADISON AVE
Practice Address - Street 2:
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92019-1046
Practice Address - Country:US
Practice Address - Phone:619-588-3166
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-29
Last Update Date:2011-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA38410225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist