Individual provider Active NPI

Jason Mou

  • Physical Therapy Assistant
  • San Gabriel, CA
National Provider Identifier
1194100917
Registry record updated Jul 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
10701 Issued in CA
Practice address
8327 Beverly Dr
San Gabriel, CA 91775-2403
Phone
(626) 283-0463
NPI assigned
Jul 22, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 22, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 10701 CA Primary

Addresses

Primary practice location

8327 Beverly Dr
San Gabriel, CA 91775-2403

Mailing address

8327 Beverly Dr
San Gabriel, CA 91775-2403

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
10701CAMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1437523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437523200000",
    "number": "1194100917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8327 BEVERLY DR",
            "city": "SAN GABRIEL",
            "state": "CA",
            "postal_code": "917752403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8327 BEVERLY DR",
            "city": "SAN GABRIEL",
            "state": "CA",
            "postal_code": "917752403",
            "telephone_number": "626-283-0463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOU",
        "first_name": "JASON",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-07-22",
        "last_updated": "2015-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": "10701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Gabriel, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2015; 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.