Active NPI
Larry Skubal, PTA
- Other Technician
- Anaheim, CA
National Provider Identifier
1235675117
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Other Technician
- License
- AT3595
- Practice address
- 861 S Harbor Blvd
Anaheim, CA 92805-5157 - Phone
- (714) 635-8131
- NPI assigned
- Jan 16, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Other Technician | 247200000X | AT3595 | CA | Primary |
Addresses
Primary practice location
861 S Harbor Blvd
Anaheim, CA 92805-5157
Mailing address
10141 Kaimu Dr
Huntington Beach, CA 92646-2508
Phone (714) 357-0333
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
| License | State | Type | Specialty |
|---|---|---|---|
| AT3595 | CA | MD | Other Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1484524800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1484524800000",
"number": "1235675117",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10141 KAIMU DR",
"city": "HUNTINGTON BEACH",
"state": "CA",
"postal_code": "926462508",
"telephone_number": "714-357-0333"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "861 S HARBOR BLVD",
"city": "ANAHEIM",
"state": "CA",
"postal_code": "928055157",
"telephone_number": "714-635-8131"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SKUBAL",
"first_name": "LARRY",
"name_prefix": "Mr.",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-01-16",
"last_updated": "2017-01-16",
"status": "A"
},
"taxonomies": [
{
"code": "247200000X",
"taxonomy_group": "",
"desc": "Technician, Other",
"state": "CA",
"license": "AT3595",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Anaheim, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.