Active NPI
Maru Gomez
- Physical Therapist
- Encino, CA
National Provider Identifier
1104283266
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 27257
- Practice address
- 16260 Ventura Blvd
Suite 600
Encino, CA 91436-2203 - Phone
- (818) 986-1977
- NPI assigned
- Jan 20, 2016
- Sex
- Female
- 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 | 27257 | CA | Primary |
Addresses
Primary practice location
16260 Ventura Blvd
Suite 600
Encino, CA 91436-2203
Mailing address
16260 Ventura Blvd
Suite 600
Encino, CA 91436-2203
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
| License | State | Type | Specialty |
|---|---|---|---|
| 27257 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1453248000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1453248000000",
"number": "1104283266",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16260 VENTURA BLVD",
"address_2": "SUITE 600",
"city": "ENCINO",
"state": "CA",
"postal_code": "914362203"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16260 VENTURA BLVD",
"address_2": "SUITE 600",
"city": "ENCINO",
"state": "CA",
"postal_code": "914362203",
"telephone_number": "818-986-1977"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOMEZ",
"first_name": "MARU",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-01-20",
"last_updated": "2016-01-20",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "27257",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Encino, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.