Active NPI
Kyle Takeo Tanamachi, MPT
- Physical Therapist
- Fremont, CA
National Provider Identifier
1023185303
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT 27699
- Practice address
- 39400 Paseo Padre Pkwy
Fremont, CA 94538-2310 - Phone
- (510) 248-3504
- NPI assigned
- Nov 29, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT 27699 | CA | Primary |
Addresses
Primary practice location
39400 Paseo Padre Pkwy
Fremont, CA 94538-2310
Mailing address
39400 Paseo Padre Pkwy
Fremont, CA 94538-2310
Phone (510) 248-3504
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 27699 | CA | MD | Clinical Social Worker |
| PT 27699 | CA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164758400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184112000000",
"number": "1023185303",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "39400 PASEO PADRE PKWY",
"city": "FREMONT",
"state": "CA",
"postal_code": "945382310",
"telephone_number": "510-248-3504"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "39400 PASEO PADRE PKWY",
"city": "FREMONT",
"state": "CA",
"postal_code": "945382310",
"telephone_number": "510-248-3504"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TANAMACHI",
"first_name": "KYLE",
"middle_name": "TAKEO",
"name_prefix": "Mr.",
"credential": "MPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-29",
"last_updated": "2007-07-11",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "PT 27699",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fremont, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.