Individual provider Active NPI

David Mull, PT

  • Physical Therapist
  • Palo Alto, CA
National Provider Identifier
1184771727
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT23977 Issued in CA
Practice address
2450 El Camino Real Ste 101
Palo Alto, CA 94306-1706
Phone
(650) 565-8090
Fax
(650) 565-8095
NPI assigned
Jan 5, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT23977 CA Primary

Addresses

Primary practice location

2450 El Camino Real Ste 101
Palo Alto, CA 94306-1706

Mailing address

1673 Sierra St
Redwood City, CA 94061-2713
Phone (650) 565-8090

Other identifiers 1

IdentifierTypeStateIssuer
PT23977OtherCALICENSE

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT23977CAMDPhysical Therapist
23977CAMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1167955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1184771727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1673 SIERRA ST",
            "city": "REDWOOD CITY",
            "state": "CA",
            "postal_code": "940612713",
            "telephone_number": "650-565-8090",
            "fax_number": "650-565-8095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 EL CAMINO REAL STE 101",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943061706",
            "telephone_number": "650-565-8090",
            "fax_number": "650-565-8095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULL",
        "first_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT23977",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "PT23977",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palo Alto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.