Active NPI
Fuquan Gao
- Massage Therapist
- Big Bear Lake, CA
National Provider Identifier
1134977226
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- BUS-00672
- Practice address
- 42137 1/2 Big Bear Blvd #I
Big Bear Lake, CA 92315 - Phone
- (909) 666-1107
- NPI assigned
- May 13, 2024
- Last updated
- May 13, 2024
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Massage Therapist | 225700000X | BUS-00672 | CA | Primary |
Addresses
Primary practice location
42137 1/2 Big Bear Blvd #I
Big Bear Lake, CA 92315
Mailing address
505 W Bencamp St Apt E
San Gabriel, CA 91776-3747
Phone (626) 620-7771
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| BUS-00672 | CA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1715558400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1715558400000",
"number": "1134977226",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "505 W BENCAMP ST APT E",
"city": "SAN GABRIEL",
"state": "CA",
"postal_code": "917763747",
"telephone_number": "626-620-7771"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "42137 1/2 BIG BEAR BLVD #I",
"city": "BIG BEAR LAKE",
"state": "CA",
"postal_code": "92315",
"telephone_number": "909-666-1107"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAO",
"first_name": "FUQUAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-05-13",
"last_updated": "2024-05-13",
"certification_date": "2024-05-03",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "CA",
"license": "BUS-00672",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Big Bear Lake, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.