Susan E Sue, P.T
Physical Therapist in San Diego, CA. Individual provider (NPI-1).
NPI number1790734150
StatusActive
Last updated in NPPESAug 30, 2022
Details
- NPI
- 1790734150
- Entity type
- Individual (NPI-1)
- Name
- Ms. Susan E Sue
- Credential
- P.T
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- May 10, 2006
- Certification date
- Aug 30, 2022
- Last updated
- Aug 30, 2022
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - PHYSICAL THERAPIST IN PRIVATE PRACTICE
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225100000X | Physical Therapist | PT10806 | CA | Yes |
Practice location
9909 Mira Mesa BlvdSte. 120
San Diego, CA 92131-1056
Phone 858-693-0436 · Fax 858-693-0437
Mailing address
3070 Madison StCarlsbad, CA 92008-2310
Phone 760-591-7750 · Fax 760-294-9813
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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