Active NPI
Michael Emman Ugoy Manansala, PTA
- Physical Therapy Assistant
- Los Angeles, CA
National Provider Identifier
1245886324
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 49945
- Practice address
- 330 N Hayworth Ave
Los Angeles, CA 90048-2702 - Phone
- (323) 852-9200
- NPI assigned
- Aug 14, 2019
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 49945 | CA | Primary |
Addresses
Primary practice location
330 N Hayworth Ave
Los Angeles, CA 90048-2702
Mailing address
14643 Moody St
Panorama City, CA 91402-1010
Phone (818) 633-6109
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 |
|---|---|---|---|
| 49945 | CA | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1565740800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1565740800000",
"number": "1245886324",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14643 MOODY ST",
"city": "PANORAMA CITY",
"state": "CA",
"postal_code": "914021010",
"telephone_number": "818-633-6109"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "330 N HAYWORTH AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900482702",
"telephone_number": "323-852-9200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANANSALA",
"first_name": "MICHAEL EMMAN",
"middle_name": "UGOY",
"credential": "PTA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-08-14",
"last_updated": "2019-08-14",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "CA",
"license": "49945",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.