Active NPI
Andreo Bautista Garcia, PTA
- Physical Therapy Assistant
- Van Nuys, CA
National Provider Identifier
1154887438
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 49732
- Practice address
- 14600 Sherman Way Ste 300
Van Nuys, CA 91405-2272 - Phone
- (818) 756-2563
- NPI assigned
- Feb 12, 2019
- 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 |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 49732 | CA | Primary |
Addresses
Primary practice location
14600 Sherman Way Ste 300
Van Nuys, CA 91405-2272
Mailing address
2272 Baxter St
Los Angeles, CA 90039-3663
Phone (818) 489-6864
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 |
|---|---|---|---|
| 49732 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1549929600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1549929600000",
"number": "1154887438",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2272 BAXTER ST",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900393663",
"telephone_number": "818-489-6864"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14600 SHERMAN WAY STE 300",
"city": "VAN NUYS",
"state": "CA",
"postal_code": "914052272",
"telephone_number": "818-756-2563"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GARCIA",
"first_name": "ANDREO",
"middle_name": "BAUTISTA",
"name_prefix": "Mr.",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-02-12",
"last_updated": "2019-02-12",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "CA",
"license": "49732",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Van Nuys, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.