NPIMap

Organization Active NPI

Park Medical Physical Therapy, Prof Corp

  • Prosthetic/Orthotic Supplier
  • San Diego, CA
National Provider Identifier
1295904308
Registry record updated Feb 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
License
PT7388 Issued in CA
Legal business name
PARK MEDICAL PHYSICAL THERAPY, PROF CORP
Practice address
4120 W Point Loma Blvd
San Diego, CA 92110-5605
Phone
(619) 297-2544
Fax
(619) 297-2752
NPI assigned
Feb 22, 2008
Last updated
Feb 27, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2008

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

Authorized official

Name
Linda Joyce Christensen, PTNPI 1811034028
Title
President/Owner
Phone
(619) 297-2544

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X PT7388 CA
Customized Equipment (DME) 332BC3200X PT7388 CA
Prosthetic/Orthotic Supplier 335E00000X PT7388 CA Primary

Addresses

Primary practice location

4120 W Point Loma Blvd
San Diego, CA 92110-5605

Mailing address

4136 Bachman PL
San Diego, CA 92103-2028
Phone (619) 297-2544

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1203638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204070400000",
    "number": "1295904308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4136 BACHMAN PL",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921032028",
            "telephone_number": "619-297-2544",
            "fax_number": "619-297-2752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4120 W POINT LOMA BLVD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921105605",
            "telephone_number": "619-297-2544",
            "fax_number": "619-297-2752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK MEDICAL PHYSICAL THERAPY, PROF CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-22",
        "last_updated": "2008-02-27",
        "status": "A",
        "authorized_official_last_name": "CHRISTENSEN",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "JOYCE",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "619-297-2544",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "CA",
            "license": "PT7388",
            "primary": false
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "CA",
            "license": "PT7388",
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "CA",
            "license": "PT7388",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2008; 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.