NPIMap

Organization Active NPI

Eugene a. Shales Physical Therapy Inc.

  • Physical Therapist
  • Los Angeles, CA
National Provider Identifier
1164595633
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
7354 Issued in CA
Legal business name
EUGENE A. SHALES PHYSICAL THERAPY INC.
Practice address
10817 Santa Monica Blvd
#300
Los Angeles, CA 90025-4655
Phone
(310) 474-8111
Fax
(310) 474-3237
NPI assigned
Nov 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. John Mahfet, PHYSICAL THERAPISTNPI 1104995513
Title
Vice President
Phone
(310) 474-8111

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 7354 CA Primary

Addresses

Primary practice location

10817 Santa Monica Blvd
#300
Los Angeles, CA 90025-4655

Mailing address

10817 Santa Monica Blvd
#300
Los Angeles, CA 90025-4655
Phone (310) 474-8111

National Provider Directory

National Provider Directory

Locations

10817 Santa Monica Blvd
Ste 300
Los Angeles, CA 90025
Phone (310) 474-8111

10817 Santa Monica Blvd
Los Angeles, CA 90025

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1164595633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10817 SANTA MONICA BLVD",
            "address_2": "#300",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900254655",
            "telephone_number": "310-474-8111",
            "fax_number": "310-474-3237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10817 SANTA MONICA BLVD",
            "address_2": "#300",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900254655",
            "telephone_number": "310-474-8111",
            "fax_number": "310-474-3237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EUGENE A. SHALES PHYSICAL THERAPY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MAHFET",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "310-474-8111",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PHYSICAL THERAPIST"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "7354",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.