Source Mobility Incorporated

Primary specialty

Geriatric Physical TherapistTaxonomy code 2251G0304X

Legal business name

SOURCE MOBILITY INCORPORATED

Practice address

5150 Candlewood St
Lakewood, CA 90712-1925

Phone

(562) 534-1134

NPI assigned

Jan 23, 2023

Organization subpart

No

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

Authorized official

Name

Ms. Zaara Gatson, PTA

Title

Ce0

Phone

(562) 259-4119

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1674432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676332800000",
    "number": "1265147458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5150 CANDLEWOOD ST",
            "city": "LAKEWOOD",
            "state": "CA",
            "postal_code": "907121925",
            "telephone_number": "562-534-1134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5150 CANDLEWOOD ST",
            "city": "LAKEWOOD",
            "state": "CA",
            "postal_code": "907121925",
            "telephone_number": "562-534-1134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOURCE MOBILITY INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-23",
        "last_updated": "2023-02-14",
        "certification_date": "2023-02-12",
        "status": "A",
        "authorized_official_last_name": "GATSON",
        "authorized_official_first_name": "ZAARA",
        "authorized_official_title_or_position": "CE0",
        "authorized_official_telephone_number": "562-259-4119",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "PTA"
    },
    "taxonomies": [
        {
            "code": "2251G0304X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Geriatrics",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Geriatric Physical Therapist in Lakewood, CA
• Providers in Lakewood, CA by specialty
• Geriatric Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2023; 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.