Active NPI
Mario Rabago Carandang Jr.
- Occupational Therapist
- Los Angeles, CA
National Provider Identifier
1053701490
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 3861
- Practice address
- 1320 N Kenmore Ave
Los Angeles, CA 90027-5806 - Phone
- (323) 503-6590
- NPI assigned
- Jan 23, 2015
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 3861 | CA | Primary |
Addresses
Primary practice location
1320 N Kenmore Ave
Los Angeles, CA 90027-5806
Mailing address
1320 N Kenmore Ave
Los Angeles, CA 90027-5806
Phone (323) 503-6590
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 |
|---|---|---|---|
| 3861 | CA | MD | School Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| West Wellness Physical Therapy & Rehab Inc | Occupational Therapist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Occupational Therapist
- Los Angeles, CA
- NPI 1205208196
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1421971200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1421971200000",
"number": "1053701490",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1320 N KENMORE AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900275806",
"telephone_number": "323-503-6590"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1320 N KENMORE AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900275806",
"telephone_number": "323-503-6590"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARANDANG",
"first_name": "MARIO",
"middle_name": "RABAGO",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-01-23",
"last_updated": "2015-01-23",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CA",
"license": "3861",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.