NPIMap

Organization Active NPI

Myofascial Health Center of la Jolla

  • Physical Therapy Clinic/Center
  • La Jolla, CA
National Provider Identifier
1215238399
Registry record updated Nov 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
2877502 Issued in CA
Legal business name
MYOFASCIAL HEALTH CENTER OF LA JOLLA
Practice address
7450 Girard Ave
La Jolla, CA 92037-5142
Phone
(858) 454-9769
Fax
(858) 454-0384
NPI assigned
Nov 5, 2010
Last updated
Nov 5, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2010

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

Authorized official

Name
Audra Moore
Title
Office Manager
Phone
(858) 454-9769

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 2877502 CA Primary

Addresses

Primary practice location

7450 Girard Ave
La Jolla, CA 92037-5142

Mailing address

7450 Girard Ave
La Jolla
La Jolla, CA 92037-5142
Phone (858) 454-9769

National Provider Directory

National Provider Directory

Locations

7450 Girard Ave
La Jolla, CA 92037
Phone (858) 454-9769

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1288915200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288915200000",
    "number": "1215238399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7450 GIRARD AVE",
            "address_2": "LA JOLLA",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920375142",
            "telephone_number": "858-454-9769",
            "fax_number": "858-454-0384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7450 GIRARD AVE",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920375142",
            "telephone_number": "858-454-9769",
            "fax_number": "858-454-0384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MYOFASCIAL HEALTH CENTER OF LA JOLLA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-05",
        "last_updated": "2010-11-05",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "AUDRA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "858-454-9769"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "CA",
            "license": "2877502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Jolla, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2010; 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.