Individual provider Active NPI

Joemar T Pablo

  • Physical Therapy Assistant
  • Carson, CA
National Provider Identifier
1083237531
Registry record updated May 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
50573 Issued in CA
Practice address
412 E 231St St
Carson, CA 90745-4922
Phone
(562) 391-3691
NPI assigned
May 19, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 19, 2020

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 50573 CA Primary

Addresses

Primary practice location

412 E 231St St
Carson, CA 90745-4922

Mailing address

412 E 231St St
Carson, CA 90745-4922
Phone (562) 391-3691

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
50573CAMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1589846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589846400000",
    "number": "1083237531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "412 E 231ST ST",
            "city": "CARSON",
            "state": "CA",
            "postal_code": "907454922",
            "telephone_number": "562-391-3691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 E 231ST ST",
            "city": "CARSON",
            "state": "CA",
            "postal_code": "907454922",
            "telephone_number": "562-391-3691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PABLO",
        "first_name": "JOEMAR",
        "middle_name": "T",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-05-19",
        "last_updated": "2020-05-19",
        "certification_date": "2020-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": "50573",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carson, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 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.