Active NPI
Justin Dean Border, OTR,L
- Occupational Therapist
- El Segundo, CA
National Provider Identifier
1124237169
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 5401
- Practice address
- 330 Concord St Unit a
El Segundo, CA 90245-3741 - Phone
- (323) 722-8610
- NPI assigned
- May 22, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 5401 | CA | Primary |
Addresses
Primary practice location
330 Concord St Unit a
El Segundo, CA 90245-3741
Mailing address
330 Concord St Unit a
El Segundo, CA 90245-3741
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
Care Compare profile
Medicare Care Compare- Specialty
- Occupational Therapist in Private Practice
- Education
- Other, 1998
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
1335 Strassner Dr
Saint Louis, MO 63144-1872
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5401 | CA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179792000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1263254400000",
"number": "1124237169",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "330 CONCORD ST UNIT A",
"city": "EL SEGUNDO",
"state": "CA",
"postal_code": "902453741"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "330 CONCORD ST UNIT A",
"city": "EL SEGUNDO",
"state": "CA",
"postal_code": "902453741",
"telephone_number": "323-722-8610"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BORDER",
"first_name": "JUSTIN",
"middle_name": "DEAN",
"credential": "OTR,L",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-22",
"last_updated": "2010-01-12",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CA",
"license": "5401",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in El Segundo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- 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.