Individual provider Active NPI

Jim Shigeru Honda, PT

  • Physical Therapist
  • Los Alamitos, CA
National Provider Identifier
1154481570
Registry record updated Aug 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT25312 Issued in CA
Practice address
5152 Katella Ave
Suite 106
Los Alamitos, CA 90720-2817
Phone
(562) 431-6004
Fax
(562) 431-9854
NPI assigned
Dec 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2016

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 PT25312 CA Primary

Addresses

Primary practice location

5152 Katella Ave
Suite 106
Los Alamitos, CA 90720-2817

Mailing address

5152 Katella Ave
Suite 106
Los Alamitos, CA 90720
Phone (562) 431-6004

Other identifiers 1

IdentifierTypeStateIssuer
PT25312OtherCAPT LICENSE

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

NPI Registry JSON

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470182400000",
    "number": "1154481570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5152 KATELLA AVE",
            "address_2": "SUITE 106",
            "city": "LOS ALAMITOS",
            "state": "CA",
            "postal_code": "90720",
            "telephone_number": "562-431-6004",
            "fax_number": "562-431-9854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5152 KATELLA AVE",
            "address_2": "SUITE 106",
            "city": "LOS ALAMITOS",
            "state": "CA",
            "postal_code": "907202817",
            "telephone_number": "562-431-6004",
            "fax_number": "562-431-9854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HONDA",
        "first_name": "JIM",
        "middle_name": "SHIGERU",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-08",
        "last_updated": "2016-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT25312",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PT LICENSE",
            "identifier": "PT25312",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Alamitos, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2016; 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.