NPIMap

Organization Active NPI

Wakabayashi Physical Therapy Inc.

  • Physical Therapist
  • Montrose, CA
National Provider Identifier
1114243904
Registry record updated Oct 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
36638 Issued in CA
Legal business name
WAKABAYASHI PHYSICAL THERAPY INC.
Practice address
4105 Ocean View Blvd
Suite a
Montrose, CA 91020-1520
Phone
(818) 792-5143
NPI assigned
Apr 19, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2010

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

Authorized official

Name
Amy Wakabayashi, PT
Title
Owner
Phone
(858) 414-6552

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 36638 CA Primary

Addresses

Primary practice location

4105 Ocean View Blvd
Suite a
Montrose, CA 91020-1520

Mailing address

4105 Ocean View Blvd
Suite a
Montrose, CA 91020-1520
Phone (818) 792-5143

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1271635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288051200000",
    "number": "1114243904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4105 OCEAN VIEW BLVD",
            "address_2": "SUITE A",
            "city": "MONTROSE",
            "state": "CA",
            "postal_code": "910201520",
            "telephone_number": "818-792-5143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4105 OCEAN VIEW BLVD",
            "address_2": "SUITE A",
            "city": "MONTROSE",
            "state": "CA",
            "postal_code": "910201520",
            "telephone_number": "818-792-5143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAKABAYASHI PHYSICAL THERAPY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-19",
        "last_updated": "2010-10-26",
        "status": "A",
        "authorized_official_last_name": "WAKABAYASHI",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "858-414-6552",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "36638",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montrose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2010; 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.