Lisa Fukuzato, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT42778 Issued in CA

Practice address

1640 Marengo St # St-102
Los Angeles, CA 90033-1036

Phone

(323) 865-1200

NPI assigned

Jun 20, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Usc Care Medical Group, Inc

  • General Practice Physician
  • Los Angeles, CA
  • NPI 1902846306
  Medicare reassignment NPD
• Usc Care Medical Group, Inc

  • Durable Medical Equipment & Medical Supplies
  • Pasadena, CA
  • NPI 1427937390
  NPD
• Keck Medical Center of Usc

  • General Acute Care Hospital
  • Los Angeles, CA
  • NPI 1417554528
  NPD (past)
• Usc University Hospital, Inc.

  • Psychiatric Hospital Unit
  • Los Angeles, CA
  • NPI 1790718500
  NPD (past)
• Usc Verdugo Hills Hospital, LLC

  • General Acute Care Hospital
  • Glendale, CA
  • NPI 1265875207
  NPD (past)

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

{
    "created_epoch": "1434758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1134501653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31309",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900310309",
            "telephone_number": "323-865-1200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1640 MARENGO ST # ST-102",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900331036",
            "telephone_number": "323-865-1200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUKUZATO",
        "first_name": "LISA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-20",
        "last_updated": "2023-11-27",
        "certification_date": "2020-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT42778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lisa.fukuzato@direct.usc.edu",
            "affiliation": "Y",
            "affiliationName": "USC CARE MEDICAL GROUP, INC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1640 Marengo St # St-102",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900331036",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Randall Fukunaga, RPH
• Akiko Fukuoka
• Emi Fukuoka, MA, BCBA
• Susan Naomi Fukushima, MD
• Miika Fukuwa, APRN
• Fulbright Dental Group, PC
• Jennifer A Fulcher, M.D., PH.D.
• Wesley Fulgencio
• Sonya Fulgham, MFT
• Isaiah Fulghum

• Physical Therapist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.