Individual provider Active NPI

Lillian Maglaris Gabaldon

  • Occupational Therapist
  • Inglewood, CA
National Provider Identifier
1093592776
Registry record updated Sep 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
25469 Issued in CA
Practice address
575 E Hardy St Ste 105
Inglewood, CA 90301-4040
Phone
(310) 412-0100
Fax
(310) 412-0110
NPI assigned
Sep 14, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225X00000X 25469 CA Primary

Addresses

Primary practice location

575 E Hardy St Ste 105
Inglewood, CA 90301-4040

Mailing address

9250 Reseda Blvd Ste 16
Northridge, CA 91324-5213
Phone (310) 412-0100

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230927002618 CA Practitioner - Occupational Therapist in Private Practice 8426402298 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Nova Southeastern College of Osteo Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
RJ Physical Therapy Group IncGroup PAC ID 9234411463, 6 clinicians

Practice addresses (Care Compare)

575 E Hardy St
Suite 105
Inglewood, CA 90301-4040
Phone (310) 412-0100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
25469CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Stevenson Orthopaedic Medical Clinic Single Specialty CurrentSince Sep 17, 2023 Accepting new patients
RJ Physical Therapy Group Inc Single Specialty CurrentSince Sep 19, 2023 Accepting new patients

Locations

575 E Hardy St
Ste 105
Inglewood, CA 90301
Phone (310) 412-0100

Organizations & group practices 2

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": "1694649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694649600000",
    "number": "1093592776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9250 RESEDA BLVD STE 16",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913245213",
            "telephone_number": "310-412-0100",
            "fax_number": "310-412-0110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 E HARDY ST STE 105",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903014040",
            "telephone_number": "310-412-0100",
            "fax_number": "310-412-0110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAGLARIS GABALDON",
        "first_name": "LILLIAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-14",
        "last_updated": "2023-09-14",
        "certification_date": "2023-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "25469",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Inglewood, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2023; 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.