Joebert Abaygar Tan

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

28519 Issued in CA

Practice address

10667 White Oak Ave
Granada Hills, CA 91344-5931

Phone

(818) 368-9484

NPI assigned

Apr 14, 2021

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

Locations

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.

• SG Mikita RPT a Physical Therapy Corporation

  • Physical Therapy Clinic/Center
  • Granada Hills, CA
  • NPI 1487826889

  Physical Therapist

  NPD

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

{
    "created_epoch": "1618358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618358400000",
    "number": "1235710096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12625 STAGG ST",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916052135",
            "telephone_number": "818-625-9537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10667 WHITE OAK AVE",
            "city": "GRANADA HILLS",
            "state": "CA",
            "postal_code": "913445931",
            "telephone_number": "818-368-9484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAN",
        "first_name": "JOEBERT",
        "middle_name": "ABAYGAR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-14",
        "last_updated": "2021-04-14",
        "certification_date": "2021-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "28519",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Synchrony Hospice Inc
• Betty Leong Tabora, RN
• Mary Elizabeth Tahi
• Yuka Takeuchi, LCSW
• Takoosh Abrahamian
• Karlu Tan, P.T
• Anie Tatavos-Gharajeh, PHARM. D
• Rozin Tatevosyan
• Mike Tchakmakjian
• Tender at Home LLC

• Physical Therapist in Granada Hills, CA
• Providers in Granada Hills, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2021; 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.