Individual provider Active NPI

Brandon Oscar Villalobos, PT, DPT

  • Physical Therapist
  • San Diego, CA
National Provider Identifier
1104657444
Registry record updated Aug 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
306434 Issued in CA
Practice address
15373 Innovation Dr Ste 220
San Diego, CA 92128-3425
Phone
(858) 400-8281
NPI assigned
Aug 9, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 306434 CA Primary

Addresses

Primary practice location

15373 Innovation Dr Ste 220
San Diego, CA 92128-3425

Mailing address

8615 Robles Dr Unit G
San Diego, CA 92119-1454
Phone (661) 319-7777

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240830002105 CA Practitioner - Physical Therapist in Private Practice 8325587538 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eggleton and Langton Physical Therapy Management ServicesGroup PAC ID 0840192530, 64 clinicians

Practice addresses (Care Compare)

15373 Innovation Dr
Suite 220
San Diego, CA 92128-3425
Phone (858) 592-8855

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Eggleton & Langton Physical Therapy Management Services Physical Therapist CurrentSince Aug 5, 2024 Accepting new patients
Eggleton & Langton Physical Therapy Management Services Physical Therapist CurrentSince Aug 5, 2024 Accepting new patients
Eggleton & Langton Physical Therapy Management Services Physical Therapist Past Accepting new patients
Eggleton Langton Physical Therapy Management Services Physical Therapist Past Accepting new patients
Eggleton & Langton Physical Therapy Management Services Physical Therapist Past Accepting new patients

Locations

2536 Rockwood Ave
Calexico, CA 92231
Phone (760) 768-3422

2437 Fenton St
Ste B
Chula Vista, CA 91914
Phone (619) 656-5176

317 N El Camino Real
Ste 210
Encinitas, CA 92024
Phone (760) 337-1144

15373 Innovation Dr
Ste 220
San Diego, CA 92128
Phone (858) 217-4369

10225 Austin Dr
Ste 204
Spring Valley, CA 91978
Phone (619) 670-4567

2600 Dallas Pkwy
Ste 290
Frisco, TX 75034
Phone (945) 260-0010

Organizations & group practices 5

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": "1723161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723161600000",
    "number": "1104657444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8615 ROBLES DR UNIT G",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921191454",
            "telephone_number": "661-319-7777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15373 INNOVATION DR STE 220",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921283425",
            "telephone_number": "858-400-8281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLALOBOS",
        "first_name": "BRANDON",
        "middle_name": "OSCAR",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-08-09",
        "last_updated": "2024-08-09",
        "certification_date": "2024-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "306434",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2024; 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.