NPIMap

Individual provider Active NPI

Liza Trinidad McGill, PT, DPT

  • Physical Therapist
  • Hawthorne, CA
National Provider Identifier
1205026838
Registry record updated Jan 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
33839 Issued in CA
Practice address
14650 Aviation Blvd
Suite 100
Hawthorne, CA 90250-6668
Phone
(310) 725-8505
Fax
(310) 725-8509
NPI assigned
Jul 30, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2022

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 33839 CA Primary

Addresses

Primary practice location

14650 Aviation Blvd
Suite 100
Hawthorne, CA 90250-6668

Mailing address

1418 Amherst Ave Apt 9
Los Angeles, CA 90025-0510
Phone (310) 820-8837

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq Health Information Exchange (HIE) The Permanente Medical Group

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
33839CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Davis and Derosa Physical Therapy, Inc Physical Therapist PastSince Jan 18, 2003 Accepting new patients
Manhattan Beach Pacific Physical Therapy Inc Physical Therapist PastSince Mar 1, 2017 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1185753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641168000000",
    "number": "1205026838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1418 AMHERST AVE APT 9",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900250510",
            "telephone_number": "310-820-8837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14650 AVIATION BLVD",
            "address_2": "SUITE 100",
            "city": "HAWTHORNE",
            "state": "CA",
            "postal_code": "902506668",
            "telephone_number": "310-725-8505",
            "fax_number": "310-725-8509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGILL",
        "first_name": "LIZA",
        "middle_name": "TRINIDAD",
        "name_prefix": "Mrs.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-30",
        "last_updated": "2022-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "33839",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "710 Lawrence Expy",
            "city": "Santa Clara",
            "state": "CA",
            "country_code": "US",
            "postal_code": "950515173",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hawthorne, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2022; 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.