Individual provider Active NPI

Paul Andre Lopez Ambulo, PT

  • Physical Therapist
  • Garden Grove, CA
National Provider Identifier
1144400243
Registry record updated Sep 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
13151 Brookhurst St
Garden Grove, CA 92843-1079
Phone
(562) 481-7833
NPI assigned
Nov 7, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2014

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 Primary

Addresses

Primary practice location

13151 Brookhurst St
Garden Grove, CA 92843-1079

Mailing address

13151 Brookhurst St
Garden Grove, CA 92843-1079
Phone (562) 481-7833

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

Practice roles

OrganizationSpecialtyStatusNew patients
Physical Rehabilitation Specialist,Inc Physical Therapist CurrentSince Aug 1, 2011 Accepting new patients
Bodee Inc Physical Therapist Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1194393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412035200000",
    "number": "1144400243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13151 BROOKHURST ST",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928431079",
            "telephone_number": "562-481-7833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13151 BROOKHURST ST",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928431079",
            "telephone_number": "562-481-7833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMBULO",
        "first_name": "PAUL ANDRE",
        "middle_name": "LOPEZ",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-07",
        "last_updated": "2014-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden Grove, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2014; 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.