Custom P.T., a Physical Therapy Corp

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

CUSTOM P.T., A PHYSICAL THERAPY CORP

Practice address

22122 Sherman Way
Suite 106
Canoga Park, CA 91303-1140

Phone

(818) 592-6030

Fax

(818) 592-6034

NPI assigned

Mar 12, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Linda Paolone

Title

Operations Manager

Phone

(805) 446-3141

Specialties & licenses 1

Addresses

Other names 1

• Custom Physicial Therapy Doing business as

Tax ID family

Custom Physical Therapy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Custom P.T., a Physical Therapy Corp

  • Orthopedic Physical Therapist
  • Thousand Oaks, CA
  • NPI 1639107626
  NPD tax ID

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Samuel Richard Di Giovanni, PT

  • Physical Therapist
  • Simi Valley, CA
  • NPI 1780929299
  NPD (past)
• Karissa Dawn Ly, PT, DPT

  • Physical Therapist
  • Canoga Park, CA
  • NPI 1477090181
  NPD (past)
• Lisa Ann Modera, DPT

  • Orthopedic Physical Therapist
  • Thousand Oaks, CA
  • NPI 1588142681
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415318400000",
    "number": "1043342397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 ROLLING OAKS DRIVE",
            "address_2": "SUITE 210",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913611088",
            "telephone_number": "805-446-3141",
            "fax_number": "805-446-3140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22122 SHERMAN WAY",
            "address_2": "SUITE 106",
            "city": "CANOGA PARK",
            "state": "CA",
            "postal_code": "913031140",
            "telephone_number": "818-592-6030",
            "fax_number": "818-592-6034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUSTOM P.T., A PHYSICAL THERAPY CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-12",
        "last_updated": "2014-11-07",
        "status": "A",
        "authorized_official_last_name": "PAOLONE",
        "authorized_official_first_name": "LINDA",
        "authorized_official_title_or_position": "OPERATIONS MANAGER",
        "authorized_official_telephone_number": "805-446-3141",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Custom Physicial Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sofia Cruz
• Justin Cuevas
• Marilyn Cuevas
• Cultural Bridges Treatment Center
• Sarah Curry
• Cvpac LLC
• Cyclosporine Testing Labs
• Maureen M. Cyr, LCSW
• Beverly Ann D'Cunha
• Inna Dadashyan, NP

• All providers in Canoga Park, CA
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.