Associated Sports Therapy Medical Center

Primary specialty

SpecialistTaxonomy code 174400000X

License

17107 Issued in CA

Legal business name

ASSOCIATED SPORTS THERAPY MEDICAL CENTER

Practice address

880 S Atlantic Blvd
Suite 205
Monterey Park, CA 91754-4700

Phone

(626) 828-3577

Fax

(626) 308-2083

NPI assigned

Jul 8, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Alicia Ontiveros

Title

Administrator

Phone

(626) 289-0178

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

• Eastside Orthopedic Medical Associates

  • Specialist
  • Monterey Park, CA
  • NPI 1235210089

  Member Of

  NPD member

Practitioners 3

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

• Tomas Saucedo, M.D.

  • Specialist
  • Monterey Park, CA
  • NPI 1104872787
  Medicare reassignment NPD
• Albert Quirap Escobar, PHYSICAL THERAPIST

  • Physical Therapy Clinic/Center
  • Montebello, CA
  • NPI 1942448923

  Single Specialty

  NPD (past)
• Tara Martinez, DPT

  • Physical Therapist
  • Monterey Park, CA
  • NPI 1750784591
  NPD (past)

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597104000000",
    "number": "1174556971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "880 S ATLANTIC BLVD",
            "address_2": "SUITE 205",
            "city": "MONTEREY PARK",
            "state": "CA",
            "postal_code": "917544700",
            "telephone_number": "626-828-3577",
            "fax_number": "626-308-2083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "880 S ATLANTIC BLVD",
            "address_2": "SUITE 205",
            "city": "MONTEREY PARK",
            "state": "CA",
            "postal_code": "917544700",
            "telephone_number": "626-828-3577",
            "fax_number": "626-308-2083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASSOCIATED SPORTS THERAPY MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-08",
        "last_updated": "2020-08-11",
        "certification_date": "2020-08-11",
        "status": "A",
        "authorized_official_last_name": "ONTIVEROS",
        "authorized_official_first_name": "ALICIA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "626-289-0178",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "17107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Attentive Care

• Specialist in Monterey Park, CA
• Providers in Monterey Park, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.