Russell Lee Physical Therapy, Inc

Primary specialty

SpecialistTaxonomy code 174400000X

License

PT 5791 Issued in CA

Legal business name

RUSSELL LEE PHYSICAL THERAPY, INC

Practice address

31884 Castaic Rd
Suite C-3
Castaic, CA 91384-3946

Phone

(661) 295-0078

Fax

(661) 295-6783

NPI assigned

Oct 19, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Russell Raymond Lee, PTNPI 1467532150

Title

Owner/Physical Therapist

Phone

(661) 295-0078

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Russell Raymond Lee, PT

  • Specialist
  • Castaic, CA
  • NPI 1467532150
  Authorized official Same address or phone

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1063594471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31884 CASTAIC RD",
            "address_2": "SUITE C-3",
            "city": "CASTAIC",
            "state": "CA",
            "postal_code": "913843946",
            "telephone_number": "661-295-0078",
            "fax_number": "661-295-6783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31884 CASTAIC RD",
            "address_2": "SUITE C-3",
            "city": "CASTAIC",
            "state": "CA",
            "postal_code": "913843946",
            "telephone_number": "661-295-0078",
            "fax_number": "661-295-6783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUSSELL LEE PHYSICAL THERAPY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_middle_name": "RAYMOND",
        "authorized_official_title_or_position": "OWNER/PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "661-295-0078",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "PT 5791",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Michelle L Salas, M.A., BCBA
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• Specialist in Castaic, CA
• Providers in Castaic, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.