Active NPI
Omi Iwasaki, PT, DPT, OCS, ATC
- Orthopedic Physical Therapist
- Santa Monica, CA
National Provider Identifier
1154483915
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopedic Physical Therapist
- License
- 25044
- Practice address
- 2020 Santa Monica Blvd
Suite 401
Santa Monica, CA 90404-2023 - Phone
- (310) 573-8866
- NPI assigned
- Dec 15, 2006
- Last updated
- Dec 15, 2009
- 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 |
|---|---|---|---|---|
| Orthopedic Physical Therapist | 2251X0800X | 25044 | CA | Primary |
Addresses
Primary practice location
2020 Santa Monica Blvd
Suite 401
Santa Monica, CA 90404-2023
Mailing address
18400 Avalon Blvd
Suite 800
Carson, CA 90746-2172
Phone (310) 630-2290
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 |
|---|---|---|---|
| 25044 | CA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Exos - Athletes' Performance Los Angeles LLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Physical Therapist
- Carson, CA
- NPI 1083776009
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166140800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1260835200000",
"number": "1154483915",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18400 AVALON BLVD",
"address_2": "SUITE 800",
"city": "CARSON",
"state": "CA",
"postal_code": "907462172",
"telephone_number": "310-630-2290"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2020 SANTA MONICA BLVD",
"address_2": "SUITE 401",
"city": "SANTA MONICA",
"state": "CA",
"postal_code": "904042023",
"telephone_number": "310-573-8866"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IWASAKI",
"first_name": "OMI",
"name_prefix": "Mr.",
"credential": "PT, DPT, OCS, ATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-15",
"last_updated": "2009-12-15",
"status": "A"
},
"taxonomies": [
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"state": "CA",
"license": "25044",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Monica, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.