Individual provider Active NPI

Abtin Anvari, PT, DPT

  • Sports Physical Therapist
  • Corona, CA
National Provider Identifier
1063084093
Registry record updated Jan 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physical TherapistTaxonomy code 2251S0007X
License
PT300341 Issued in CA
Practice address
1280 Corona Pointe CT Ste 118
Corona, CA 92879-1770
Phone
(951) 340-3402
Fax
(951) 340-3416
NPI assigned
Jul 9, 2021
Last updated
Jan 20, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 20, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT300341 CA
Sports Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 2251S0007X PT300341 CA Primary

Addresses

Primary practice location

1280 Corona Pointe CT Ste 118
Corona, CA 92879-1770

Mailing address

30428 Haun Rd Ste 810
Menifee, CA 92584-6824
Phone (951) 696-9353

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231027000036 CA Practitioner - Physical Therapist in Private Practice 7517358393 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rancho Physical Therapy IncGroup PAC ID 2365346491, 29 clinicians
California Luna Care Physical Therapy PCGroup PAC ID 9638427834, 769 clinicians

Practice addresses (Care Compare)

1280 Corona Pointe CT
Suite 118
Corona, CA 92879-1770
Phone (951) 304-3402

16185 Los Gatos Blvd
Suite 205
Los Gatos, CA 95032-4569
Phone (866) 525-3175

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT300341CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Repair NB Physical Therapy, Corp Single Specialty CurrentSince Sep 29, 2023 Accepting new patients
Rancho Physical Therapy, Inc. Single Specialty CurrentSince Aug 1, 2024 Accepting new patients
Rancho Physical Therapy, Inc. Single Specialty CurrentSince Aug 1, 2024 Accepting new patients
Rancho Physical Therapy, Inc. Single Specialty Past Accepting new patients
Rancho Physical Therapy, Inc. Single Specialty Past Accepting new patients

Locations

1280 Corona Pointe Ct
Ste 118
Corona, CA 92879
Phone (951) 304-3402

7146 Edinger Ave
Huntington Beach, CA 92647
Phone (714) 377-4314

30428 Haun Rd
Ste 810
Menifee, CA 92584
Phone (951) 723-1866

24021 Alessandro Blvd
Ste 109
Moreno Valley, CA 92553
Phone (951) 485-4594

6850 Brockton Ave
Ste 212
Riverside, CA 92506
Phone (951) 534-0600

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1625788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768867200000",
    "number": "1063084093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30428 HAUN RD STE 810",
            "city": "MENIFEE",
            "state": "CA",
            "postal_code": "925846824",
            "telephone_number": "951-696-9353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1280 CORONA POINTE CT STE 118",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928791770",
            "telephone_number": "951-340-3402",
            "fax_number": "951-340-3416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANVARI",
        "first_name": "ABTIN",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-07-09",
        "last_updated": "2026-01-20",
        "certification_date": "2026-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT300341",
            "primary": false
        },
        {
            "code": "2251S0007X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist, Sports",
            "state": "CA",
            "license": "PT300341",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corona, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.