Magnolia Panganiban Gozun, OTR

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT9080 Issued in CA

Practice address

917 S Velare St
Anaheim, CA 92804-4012

Phone

(714) 776-1720

Fax

(714) 956-5052

NPI assigned

Nov 16, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Northridge Physical Therapy Center,Inc

  • Physical Therapist
  • Northridge, CA
  • NPI 1689756132
  NPD (past)

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1419897600000",
    "number": "1295808111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "917 S VELARE ST",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928044012",
            "telephone_number": "714-776-1720",
            "fax_number": "714-956-5052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "917 S VELARE ST",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928044012",
            "telephone_number": "714-776-1720",
            "fax_number": "714-956-5052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOZUN",
        "first_name": "MAGNOLIA",
        "middle_name": "PANGANIBAN",
        "credential": "OTR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-16",
        "last_updated": "2014-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "OT9080",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OCCUPATIONAL THERAPIST",
            "identifier": "OT9080",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lesley Anne Gould, M.A.
• Mark W. Gow, MD
• Morgan Gowan
• Ramesh A.M. Gowda, DDS
• Seema Goyal, MD
• GP Anaheim Ivf, PC
• GPS Hospice Care Inc.
• Grace Family Medical Center, Inc.
• Grace Family Medical Group
• Grace H Jeon M D M P H F a C S a Professional Corporation

• Occupational Therapist in Anaheim, CA
• Providers in Anaheim, CA by specialty
• Occupational Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2014; 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.