Steve Aviles, MPT, ATC

Individual provider Active NPI Physical Therapist · Diamond Bar, CA

NPI 1255436895 · NPPES record last updated Sep 9, 2016

Key facts

NPI
1255436895
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
PT22029 (CA)
Practice address
1370 Valley Vista Dr Ste 145
Diamond Bar, CA 91765-3950
Phone
(909) 861-3511
Fax
(909) 860-7900
NPI assigned
Sep 14, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 3

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.

Medicare Care Compare profile

Specialty
Physical Therapist in Private Practice
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pomona Valley Orthopedic and Sports Physical Therapy Inc (15 clinicians)

Practice addresses (Care Compare)

21015 Pathfinder Rd
Suite 100
Diamond Bar, CA 91765-4002
Phone (909) 861-3511

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20041215001069 CA Practitioner - Physical Therapist in Private Practice 2860459310 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
22029CAMDRehabilitation Psychologist
PT22029CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pomona Valley Orthopedic and Sports Physical Therapy, Inc Physical Therapist Current
since Oct 16, 2000
Accepting new patients
JM Physical Therapy Inc Physical Therapist Past Accepting new patients
Prostar Sports Training and Rehabilitation Physical Therapist Past Accepting new patients

Locations

21015 Pathfinder Rd
Ste 100
Diamond Bar, CA 91765
Phone 9098613511 ext. 305

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT22029 CA Yes

Addresses

Primary practice location

1370 Valley Vista Dr Ste 145
Diamond Bar, CA 91765-3950

Mailing address

21015 Pathfinder Rd
Ste 100
Diamond Bar, CA 91765-4002
Phone (909) 861-3511

Other providers in Diamond Bar, CA

All providers in Diamond Bar, CA · Physical Therapist in California

Sources for this page

Verify at the official NPI Registry.