Active NPI
Daniel Guptill
- Physical Therapist
- Chula Vista, CA
National Provider Identifier
1306052915
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 33693
- Practice address
- 480 4TH Ave
Chula Vista, CA 91910-4410 - Phone
- (619) 409-3690
- NPI assigned
- May 14, 2007
- Last updated
- Aug 15, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2305204506 | VA | |
| Physical Therapist | 225100000X | PT2925 | ME | |
| Physical Therapist | 225100000X | 33693 | CA | Primary |
Addresses
Primary practice location
480 4TH Ave
Chula Vista, CA 91910-4410
Mailing address
200 Surrey Dr
Bonita, CA 91902-2323
Phone (757) 339-5205
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 33693 | CA | MD | Chiropractor |
| PT2925 | ME | MD | Physical Therapist |
| 2305204506 | VA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179100800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1313366400000",
"number": "1306052915",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 SURREY DR",
"city": "BONITA",
"state": "CA",
"postal_code": "919022323",
"telephone_number": "757-339-5205"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "480 4TH AVE",
"city": "CHULA VISTA",
"state": "CA",
"postal_code": "919104410",
"telephone_number": "619-409-3690"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUPTILL",
"first_name": "DANIEL",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-14",
"last_updated": "2011-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "VA",
"license": "2305204506",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "ME",
"license": "PT2925",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "33693",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Chula Vista, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.