Individual provider Active NPI

Timothy M Botti Jr., DPT

  • Physical Therapist
  • San Diego, CA
National Provider Identifier
1134514136
Registry record updated Apr 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
42448 Issued in CA
Practice address
3760 Convoy St
Suite 100
San Diego, CA 92111-3742
Phone
(858) 573-9368
NPI assigned
Apr 6, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 42448 CA Primary

Addresses

Primary practice location

3760 Convoy St
Suite 100
San Diego, CA 92111-3742

Mailing address

931 Grand Ave
Suite I
San Diego, CA 92109-4043
Phone (858) 573-9368

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
42448CAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1428278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428278400000",
    "number": "1134514136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "931 GRAND AVE",
            "address_2": "SUITE I",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921094043",
            "telephone_number": "858-573-9368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3760 CONVOY ST",
            "address_2": "SUITE 100",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921113742",
            "telephone_number": "858-573-9368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOTTI",
        "first_name": "TIMOTHY",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-06",
        "last_updated": "2015-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "42448",
            "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 Apr 6, 2015; 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.