Organization Active NPI

Victoria Mangunsong

  • Physical Therapy Clinic/Center
  • Loma Linda, CA
National Provider Identifier
1184717795
Registry record updated Aug 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
PT26565 Issued in CA
Legal business name
VICTORIA MANGUNSONG
Practice address
11354 Mountain View Ave
Suite C
Loma Linda, CA 92354-3855
Phone
(909) 796-9400
NPI assigned
Oct 2, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2008

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

Authorized official

Name
Victoria P Mangunsong, MPTNPI 1699714287
Title
Owner
Phone
(909) 796-8400

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 Therapy Clinic/Center 261QP2000X PT26565 CA Primary

Addresses

Primary practice location

11354 Mountain View Ave
Suite C
Loma Linda, CA 92354-3855

Mailing address

11354 Mountain View Ave
Suite C
Loma Linda, CA 92354-3855
Phone (909) 796-9400

Other names 1

  • BODYALIGNED Former legal business name

National Provider Directory

National Provider Directory

Locations

11354 Mountain View Ave
Ste C
Loma Linda, CA 92354
Phone (909) 796-8400

Practitioners & affiliated clinicians

Practitioners 1

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": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217980800000",
    "number": "1184717795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11354 MOUNTAIN VIEW AVE",
            "address_2": "SUITE C",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923543855",
            "telephone_number": "909-796-9400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11354 MOUNTAIN VIEW AVE",
            "address_2": "SUITE C",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923543855",
            "telephone_number": "909-796-9400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICTORIA MANGUNSONG",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "last_updated": "2008-08-06",
        "status": "A",
        "authorized_official_last_name": "MANGUNSONG",
        "authorized_official_first_name": "VICTORIA",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "909-796-8400",
        "authorized_official_credential": "MPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "CA",
            "license": "PT26565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BODYALIGNED",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Loma Linda, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2008; 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.