Individual provider Active NPI

Timur Sultangareev Sultangareev

  • Massage Therapist
  • Irvine, CA
National Provider Identifier
1295639888
Registry record updated Oct 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
103976 Issued in CA
Practice address
148 Hedge Bloom
Irvine, CA 92618-1517
Phone
(213) 464-3768
NPI assigned
Oct 6, 2026
Last updated
Oct 6, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 6, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 103976 CA Primary

Addresses

Primary practice location

148 Hedge Bloom
Irvine, CA 92618-1517

Mailing address

148 Hedge Bloom
Irvine, CA 92618-1517
Phone (213) 464-3768

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

LicenseStateTypeSpecialty
103976CAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1791244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791244800000",
    "number": "1295639888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "148 HEDGE BLOOM",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926181517",
            "telephone_number": "213-464-3768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "148 HEDGE BLOOM",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926181517",
            "telephone_number": "213-464-3768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULTANGAREEV",
        "first_name": "TIMUR SULTANGAREEV",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-10-06",
        "last_updated": "2026-10-06",
        "certification_date": "2026-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "CA",
            "license": "103976",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2026; 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.