Ian Vergel R Pamintuan, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

48228 Issued in CA

Practice address

28631 S Western Ave
Suite 104a
Rancho Palos Verdes, CA 90275-0816

Phone

(310) 548-5444

Fax

(310) 548-8444

NPI assigned

Oct 12, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Excel Physical Therapy Associates Inc.

  • Physical Therapy Clinic/Center
  • Rancho Palos Verdes, CA
  • NPI 1528212784
  NPD (past)

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

{
    "created_epoch": "1476230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476230400000",
    "number": "1235689308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28631 S WESTERN AVE",
            "address_2": "SUITE 104A",
            "city": "RANCHO PALOS VERDES",
            "state": "CA",
            "postal_code": "902750816",
            "telephone_number": "310-548-5444",
            "fax_number": "310-548-8444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28631 S WESTERN AVE",
            "address_2": "SUITE 104A",
            "city": "RANCHO PALOS VERDES",
            "state": "CA",
            "postal_code": "902750816",
            "telephone_number": "310-548-5444",
            "fax_number": "310-548-8444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAMINTUAN",
        "first_name": "IAN VERGEL",
        "middle_name": "R",
        "name_prefix": "Mr.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-10-12",
        "last_updated": "2016-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": "48228",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Doris Angela Paloma, MS,PT
• Gladys Encarnacion Palomeno, M.D.
• Palos Verdes Care Cottage LLC
• Palos Verdes Villa Retirement Home
• Palos Verdes Villa Retirement Home
• Farangis Partovi, DDS
• Patriot Physical Therapy Inc
• Peak Performance PT Inc
• Patricia Dianne Pegram, M.D.
• Mitchell Orlando Pena, PT, DPT

• Physical Therapy Assistant in Rancho Palos Verdes, CA
• Providers in Rancho Palos Verdes, CA by specialty
• Physical Therapy Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 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.