Active NPI
Nastaran Pourdehmobed
- Physical Therapist
- San Diego, CA
National Provider Identifier
1134036106
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 310619
- Practice address
- 501 W Broadway
San Diego, CA 92101-3536 - Phone
- (858) 488-3597
- Fax
- (858) 724-1747
- NPI assigned
- Aug 26, 2026
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 310619 | CA | Primary |
Addresses
Primary practice location
501 W Broadway
San Diego, CA 92101-3536
Mailing address
501 W Broadway
San Diego, CA 92101-3536
Phone (858) 488-3597
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1787702400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1787702400000",
"number": "1134036106",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "501 W BROADWAY",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921013536",
"telephone_number": "858-488-3597",
"fax_number": "858-724-1747"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "501 W BROADWAY",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921013536",
"telephone_number": "858-488-3597",
"fax_number": "858-724-1747"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POURDEHMOBED",
"first_name": "NASTARAN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-08-26",
"last_updated": "2026-08-26",
"certification_date": "2026-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "310619",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.