Individual provider Active NPI

Mario Ordonez-Calderon

  • Physical Therapy Assistant
  • San Diego, CA
National Provider Identifier
1063948628
Registry record updated May 2, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
48581 Issued in CA
Practice address
404 Camino del Rio S
Unit 508
San Diego, CA 92108-3503
Phone
(619) 325-0154
NPI assigned
May 2, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2017

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 48581 CA Primary

Addresses

Primary practice location

404 Camino del Rio S
Unit 508
San Diego, CA 92108-3503

Mailing address

728 Munevar Rd
Cardiff by the Sea, CA 92007-1331
Phone (805) 390-2767

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
48581CAMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1493683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493683200000",
    "number": "1063948628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "728 MUNEVAR RD",
            "city": "CARDIFF BY THE SEA",
            "state": "CA",
            "postal_code": "920071331",
            "telephone_number": "805-390-2767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 CAMINO DEL RIO S",
            "address_2": "UNIT 508",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083503",
            "telephone_number": "619-325-0154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORDONEZ-CALDERON",
        "first_name": "MARIO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-02",
        "last_updated": "2017-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": "48581",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2017; 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.