Eric Stafford Prante, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT10428 Issued in CA

Practice address

5360 Jackson Dr Ste 110
La Mesa, CA 91942-3012

Phone

(619) 667-7000

Fax

(619) 667-4315

NPI assigned

Apr 25, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1177459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114147055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5360 JACKSON DR STE 110",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919423012",
            "telephone_number": "619-667-7000",
            "fax_number": "619-667-4315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5360 JACKSON DR STE 110",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919423012",
            "telephone_number": "619-667-7000",
            "fax_number": "619-667-4315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRANTE",
        "first_name": "ERIC",
        "middle_name": "STAFFORD",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT10428",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRACTICE NPI",
            "identifier": "1023103330",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tom J Pousti, MD
• Sean Thomas Powell, M.D.
• Venu Prabaker, M.D.
• Arudi L Prabhakar, M.D.
• Namratha Prabhu, M.D.
• Prasad Gonavarum D.D.S., Professional Corporation
• Allyson M Prather, MFT
• Susan Patricia Press, DMD
• Mark Priest
• Katherine Prince

• Physical Therapist in La Mesa, CA
• Providers in La Mesa, CA by specialty
• Physical Therapist in California

• 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.

Verify at the official NPI Registry.