Individual provider Active NPI

Cristine Hugo Metiam, PTA

  • Physical Therapy Assistant
  • Los Angeles, CA
National Provider Identifier
1114581592
Registry record updated May 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
49914 Issued in CA
Practice address
1200 S Citrus Ave Apt 10
Los Angeles, CA 90019-1647
Phone
(323) 534-3818
NPI assigned
May 1, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 49914 CA Primary

Addresses

Primary practice location

1200 S Citrus Ave Apt 10
Los Angeles, CA 90019-1647

Mailing address

1200 S Citrus Ave Apt 10
Los Angeles, CA 90019-1647
Phone (323) 534-3818

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1556668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556668800000",
    "number": "1114581592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 S CITRUS AVE APT 10",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900191647",
            "telephone_number": "323-534-3818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 S CITRUS AVE APT 10",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900191647",
            "telephone_number": "323-534-3818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "METIAM",
        "first_name": "CRISTINE",
        "middle_name": "HUGO",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-01",
        "last_updated": "2019-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": "49914",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2019; 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.