Individual provider Active NPI

Kyle Reed Iguchi, PT, DPT

  • Physical Therapist
  • Venice, CA
National Provider Identifier
1134686330
Registry record updated Feb 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT295910 Issued in CA
Practice address
1600 Main St FL 2
Venice, CA 90291-3626
Phone
(888) 859-0145
NPI assigned
Feb 23, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 23, 2023

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 PT295910 CA Primary

Addresses

Primary practice location

1600 Main St FL 2
Venice, CA 90291-3626

Mailing address

6935 Verde Ridge Rd
Rancho Palos Verdes, CA 90275-4639
Phone (310) 619-9798

Other practice location 1

6935 Verde Ridge Rd
Rancho Palos Verdes, CA 90275-4639
Phone (310) 619-9798

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
PT295910CAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1550880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677110400000",
    "number": "1134686330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6935 VERDE RIDGE RD",
            "city": "RANCHO PALOS VERDES",
            "state": "CA",
            "postal_code": "902754639",
            "telephone_number": "310-619-9798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 MAIN ST FL 2",
            "city": "VENICE",
            "state": "CA",
            "postal_code": "902913626",
            "telephone_number": "888-859-0145"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6935 Verde Ridge Rd",
            "address_purpose": "LOCATION",
            "city": "Rancho Palos Verdes",
            "state": "CA",
            "postal_code": "902754639",
            "country_code": "US",
            "telephone_number": "310-619-9798",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IGUCHI",
        "first_name": "KYLE",
        "middle_name": "REED",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-02-23",
        "last_updated": "2023-02-23",
        "certification_date": "2023-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT295910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Venice, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2023; 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.