Active NPI
Michael Lawenko De la Paz, PT PHYSICAL THERAPIS
- Physical Therapist
- San Gabriel, CA
National Provider Identifier
1083777130
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Practice address
- 438 W Las Tunas Ave
San Gabriel, CA 91776 - Phone
- (626) 570-6587
- NPI assigned
- Dec 19, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | Primary |
Addresses
Primary practice location
438 W Las Tunas Ave
San Gabriel, CA 91776
Mailing address
115 N San Marino Ave
Apt D
San Gabriel, CA 91775
Phone (626) 281-8602
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166486400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1083777130",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "115 N SAN MARINO AVE",
"address_2": "APT D",
"city": "SAN GABRIEL",
"state": "CA",
"postal_code": "91775",
"telephone_number": "626-281-8602"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "438 W LAS TUNAS AVE",
"city": "SAN GABRIEL",
"state": "CA",
"postal_code": "91776",
"telephone_number": "626-570-6587"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DE LA PAZ",
"first_name": "MICHAEL",
"middle_name": "LAWENKO",
"name_prefix": "Mr.",
"credential": "PT PHYSICAL THERAPIS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Gabriel, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.