Optimum Care Provider, Inc.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

33402 Issued in CA

Legal business name

OPTIMUM CARE PROVIDER, INC.

Practice address

12381 Bali St
Victorville, CA 92392-6825

Phone

(909) 509-6064

NPI assigned

May 31, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Eleazar Somintac Tayag, PTNPI 1245355783

Title

Ceo

Phone

(909) 509-6064

Specialties & licenses 3

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Eleazar Somintac Tayag, PT

  • Physical Therapist
  • Victorville, CA
  • NPI 1245355783
  NPD Authorized official

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

{
    "created_epoch": "1306800000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697328000000",
    "number": "1114211885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15260 ANACAPA RD STE A12",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923922565",
            "telephone_number": "909-509-6064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12381 BALI ST",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923926825",
            "telephone_number": "909-509-6064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMUM CARE PROVIDER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-31",
        "last_updated": "2023-10-15",
        "certification_date": "2023-10-15",
        "status": "A",
        "authorized_official_last_name": "TAYAG",
        "authorized_official_first_name": "ELEAZAR",
        "authorized_official_middle_name": "SOMINTAC",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "909-509-6064",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "33402",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Henry Spencer Oneal, DR.AD, LEP, CATC
• Madeleine Ong-Veloso, N.P.
• Omari Onyango, DDS
• Thein Oo, MD
• Brian Opdenhoff, PT
• Option One Home Medical Equipment, Inc
• Jose Carlos Oregel
• Max Oregon
• Omoyinka Orekoya
• Andrea Orellana

• Physical Therapist in Victorville, CA
• Providers in Victorville, CA by specialty
• Physical Therapist in California

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