Individual provider Active NPI

Sitipon Chavatipon, P.T.

  • Physical Therapist
  • Fullerton, CA
National Provider Identifier
1073534749
Registry record updated Oct 2, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
26575 Issued in CA
Practice address
2518 Threewoods LN
Fullerton, CA 92831-1059
Phone
(714) 674-0768
NPI assigned
Jul 21, 2006
Last updated
Oct 2, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2007

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 26575 CA Primary

Addresses

Primary practice location

2518 Threewoods LN
Fullerton, CA 92831-1059

Mailing address

2518 Threewoods LN
Fullerton, CA 92831-1059
Phone (714) 674-0768

Other identifiers 1

IdentifierTypeStateIssuer
PT26575OtherCALICENSE

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)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
All Care Physical Therapy Inc Physical Therapist PastSince Aug 15, 2007 Accepting new patients
Art Physical Therapy Physical Therapist PastSince Aug 1, 2007 Accepting new patients
Vendetta Chiropractic Corp. PastSince Nov 27, 2022 Accepting new patients
Westminister Physical Therapy Inc Physical Therapist PastSince May 19, 2008 Accepting new patients

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, 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": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191283200000",
    "number": "1073534749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2518 THREEWOODS LN",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928311059",
            "telephone_number": "714-674-0768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2518 THREEWOODS LN",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928311059",
            "telephone_number": "714-674-0768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAVATIPON",
        "first_name": "SITIPON",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2007-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "26575",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "PT26575",
            "state": "CA"
        }
    ],
    "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 Oct 2, 2007; 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.