Provider Demographics
NPI:1932583911
Name:PITZER, MEGAN (DPT)
Entity Type:Individual
Prefix:DR
First Name:MEGAN
Middle Name:
Last Name:PITZER
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 1:235 ANITA RD
Mailing Address - Street 2:#3
Mailing Address - City:BURLINGAME
Mailing Address - State:CA
Mailing Address - Zip Code:94010-3054
Mailing Address - Country:US
Mailing Address - Phone:317-225-3492
Mailing Address - Fax:
Practice Address - Street 1:3550 ALAMEDA DE LAS PULGAS
Practice Address - Street 2:
Practice Address - City:MENLO PARK
Practice Address - State:CA
Practice Address - Zip Code:94025-6559
Practice Address - Country:US
Practice Address - Phone:925-855-8350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-19
Last Update Date:2015-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA39568225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist