Individual provider Active NPI

Michelle Del Mundo

  • Physical Therapy Assistant
  • Fullerton, CA
National Provider Identifier
1053981688
Registry record updated Jun 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
51199 Issued in CA
Practice address
2501 E Chapman Ave Ste 160
Fullerton, CA 92831-3135
Phone
(562) 217-8317
NPI assigned
Jun 27, 2021
Last updated
Jun 27, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 51199 CA Primary

Addresses

Primary practice location

2501 E Chapman Ave Ste 160
Fullerton, CA 92831-3135

Mailing address

1544 W Katella Ave Unit 11
Anaheim, CA 92802-2728
Phone (562) 217-8317

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

LicenseStateTypeSpecialty
51199CAMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1624752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624752000000",
    "number": "1053981688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1544 W KATELLA AVE UNIT 11",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928022728",
            "telephone_number": "562-217-8317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 E CHAPMAN AVE STE 160",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928313135",
            "telephone_number": "562-217-8317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEL MUNDO",
        "first_name": "MICHELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-27",
        "last_updated": "2021-06-27",
        "certification_date": "2021-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": "51199",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fullerton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2021; 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.