Individual ProviderGraig GubelloPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address737 Pearl St, Suite 108, La Jolla, CA 92037-0056(858) 456-2114PECOS EnrollmentBased on the most recent information from CMS, provider Graig Gubello does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1316336621Provider TypeIndividualFull NameGubello, GraigTitleDr.CredentialDPTGenderMaleSole ProprietorYesEnumeration Date1/10/2015Last Updated1/10/2015Contact InformationPractice LocationPractice Address737 Pearl St, Suite 108, La Jolla, CA 92037-0056Phone(858) 456-2114Fax(858) 456-2103Mailing LocationMailing Address1562 Linwood St, San Diego, CA 92103-3729PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode225100000XPrimaryDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicense42131California