Bladimir A Polio

Primary specialty

Rehabilitation PractitionerTaxonomy code 225400000X

Practice address

108 W Victoria St
Gardena, CA 90248-3523

Phone

(310) 715-2020

NPI assigned

Aug 18, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1439856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692057600000",
    "number": "1104292663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 W VICTORIA ST",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902483523",
            "telephone_number": "310-715-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 W VICTORIA ST",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902483523",
            "telephone_number": "310-715-2020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10929 South St Ste 208B",
            "address_purpose": "LOCATION",
            "city": "Cerritos",
            "state": "CA",
            "postal_code": "907035368",
            "country_code": "US",
            "telephone_number": "562-924-5526",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10929 South St Ste 208B",
            "address_purpose": "LOCATION",
            "city": "Cerritos",
            "state": "CA",
            "postal_code": "907035368",
            "country_code": "US",
            "telephone_number": "562-924-5526",
            "fax_number": "562-974-1040",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10929 South St Ste 208B",
            "address_purpose": "LOCATION",
            "city": "Cerritos",
            "state": "CA",
            "postal_code": "907035368",
            "country_code": "US",
            "telephone_number": "562-924-5526",
            "fax_number": "562-974-1040",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2640 Industry Way",
            "address_purpose": "LOCATION",
            "city": "Lynwood",
            "state": "CA",
            "postal_code": "902624284",
            "country_code": "US",
            "telephone_number": "310-627-4525",
            "fax_number": "323-234-4477",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5849 Crocker St Unit L",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "90003",
            "country_code": "US",
            "telephone_number": "323-234-4445",
            "fax_number": "323-234-4477",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "16500 Ventura Blvd Ste 414",
            "address_purpose": "LOCATION",
            "city": "Encino",
            "state": "CA",
            "postal_code": "914365050",
            "country_code": "US",
            "telephone_number": "818-616-5022",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10929 South St Ste 208B",
            "address_purpose": "LOCATION",
            "city": "Cerritos",
            "state": "CA",
            "postal_code": "907035368",
            "country_code": "US",
            "telephone_number": "562-924-5526",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POLIO",
        "first_name": "BLADIMIR",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-08-18",
        "last_updated": "2023-08-15",
        "certification_date": "2023-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Rehabilitation Practitioner in Gardena, CA
• Providers in Gardena, CA by specialty
• Rehabilitation Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2023; 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.