Lighthouse Physical Therapy Rehab Inc

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

PT13519 Issued in CA

Legal business name

LIGHTHOUSE PHYSICAL THERAPY REHAB INC

Practice address

1314 W Glenoaks Blvd
204
Glendale, CA 91201-1978

Phone

(818) 956-0010

Fax

(818) 956-0040

NPI assigned

Oct 16, 2013

Organization subpart

No

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

Authorized official

Name

Emilio Valdes

Title

Owner

Phone

(818) 956-0010

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1381881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1391558400000",
    "number": "1184052896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1314 W GLENOAKS BLVD",
            "address_2": "204",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912011978",
            "telephone_number": "818-956-0010",
            "fax_number": "818-956-0040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1314 W GLENOAKS BLVD",
            "address_2": "204",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912011978",
            "telephone_number": "818-956-0010",
            "fax_number": "818-956-0040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIGHTHOUSE PHYSICAL THERAPY REHAB INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-16",
        "last_updated": "2014-02-05",
        "status": "A",
        "authorized_official_last_name": "VALDES",
        "authorized_official_first_name": "EMILIO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "818-956-0010"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "CA",
            "license": "PT13519",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "14256",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapy Clinic/Center in Glendale, CA
• Providers in Glendale, CA by specialty
• Physical Therapy Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2014; 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.