Individual provider Active NPI

David Edward Weberg, DPT

  • Physical Therapist
  • Brea, CA
National Provider Identifier
1063888436
Registry record updated Dec 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
42969 Issued in CA
Practice address
1800 E Lambert Rd
Suite 220
Brea, CA 92821-4370
Phone
(714) 256-5074
Fax
(714) 256-0770
NPI assigned
Aug 19, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 42969 CA Primary

Addresses

Primary practice location

1800 E Lambert Rd
Suite 220
Brea, CA 92821-4370

Mailing address

1800 E Lambert Rd
Suite 220
Brea, CA 92821-4370
Phone (714) 256-5074

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150925001948 CA Practitioner - Physical Therapist in Private Practice 3779891684 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

25821 Vermont Ave
Harbor City, CA 90710-3518
Phone (310) 325-5111

25825 Vermont Ave
Harbor City, CA 90710-3518
Phone (310) 325-5111

3900 E Pacific Coast Hwy
Long Beach, CA 90804-2013
Phone (562) 986-2200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
42969CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Feb 15, 2016 Accepting new patients
Coury & Buehler Physical Therapy - Tustin/Santa Ana, Inc. Physical Therapist CurrentSince Jul 24, 2022 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Southern California Permanente Medical Group CurrentSince Feb 15, 2016 Accepting new patients

Locations

3230 E Imperial Hwy
Ste 100
Brea, CA 92821
Phone (714) 256-5074

1800 E Lambert Rd
Ste 220
Brea, CA 92821
Phone (714) 256-5074

25825 Vermont Ave
Harbor City, CA 90710
Phone (310) 325-5111

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1439942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638921600000",
    "number": "1063888436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 E LAMBERT RD",
            "address_2": "SUITE 220",
            "city": "BREA",
            "state": "CA",
            "postal_code": "928214370",
            "telephone_number": "714-256-5074",
            "fax_number": "714-256-0770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 E LAMBERT RD",
            "address_2": "SUITE 220",
            "city": "BREA",
            "state": "CA",
            "postal_code": "928214370",
            "telephone_number": "714-256-5074",
            "fax_number": "714-256-0770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEBERG",
        "first_name": "DAVID",
        "middle_name": "EDWARD",
        "name_prefix": "Mr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-08-19",
        "last_updated": "2021-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "42969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "25825 Vermont Ave",
            "city": "Harbor City",
            "state": "CA",
            "country_code": "US",
            "postal_code": "907103518",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Brea, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2021; 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.