NPIMap

Organization Active NPI

Goodman Physical Therapy

  • Physical Therapist
  • Los Angeles, CA
National Provider Identifier
1205017514
Registry record updated Sep 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
18437 Issued in CA
Legal business name
GOODMAN PHYSICAL THERAPY
Practice address
2001 S Barrington Ave
Suite 119
Los Angeles, CA 90025-5363
Phone
(310) 441-1102
Fax
(310) 441-1088
NPI assigned
Nov 15, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2016

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

Authorized official

Name
Deena Poll Goodman, P.T.NPI 1588734636
Title
Owner/P.T.
Phone
(310) 441-1102

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X PT 18437 CA
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X 18437 CA Primary

Addresses

Primary practice location

2001 S Barrington Ave
Suite 119
Los Angeles, CA 90025-5363

Mailing address

9854 National Blvd # 437
Los Angeles, CA 90034-2713
Phone (310) 441-1102

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 18

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1195084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473811200000",
    "number": "1205017514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9854 NATIONAL BLVD # 437",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900342713",
            "telephone_number": "310-441-1102",
            "fax_number": "310-441-1088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 S BARRINGTON AVE",
            "address_2": "SUITE 119",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900255363",
            "telephone_number": "310-441-1102",
            "fax_number": "310-441-1088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOODMAN PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-15",
        "last_updated": "2016-09-14",
        "status": "A",
        "authorized_official_last_name": "GOODMAN",
        "authorized_official_first_name": "DEENA",
        "authorized_official_middle_name": "POLL",
        "authorized_official_title_or_position": "OWNER/P.T.",
        "authorized_official_telephone_number": "310-441-1102",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "PT 18437",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "18437",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2016; 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.