Active NPI
Roderick Pagaduan
- Physical Therapy Assistant
- Norwalk, CA
National Provider Identifier
1053116061
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- AT6153
- Practice address
- 12458 Sproul St
Norwalk, CA 90650-4348 - Phone
- (562) 682-1837
- NPI assigned
- Feb 14, 2025
- Sex
- Male
- Sole proprietor
- Yes
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 Therapy Assistant | 225200000X | AT6153 | CA | Primary |
Addresses
Primary practice location
12458 Sproul St
Norwalk, CA 90650-4348
Mailing address
12458 Sproul St
Norwalk, CA 90650-4348
Phone (562) 682-1837
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AT6153 | CA | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1739491200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1739491200000",
"number": "1053116061",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12458 SPROUL ST",
"city": "NORWALK",
"state": "CA",
"postal_code": "906504348",
"telephone_number": "562-682-1837"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12458 SPROUL ST",
"city": "NORWALK",
"state": "CA",
"postal_code": "906504348",
"telephone_number": "562-682-1837"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAGADUAN",
"first_name": "RODERICK",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-02-14",
"last_updated": "2025-02-14",
"certification_date": "2025-02-14",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "CA",
"license": "AT6153",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Norwalk, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.