Individual provider Active NPI

Carlos Carrera, PT.

  • Physical Therapist
  • Glendora, CA
National Provider Identifier
1316064264
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT18887 Issued in CA
Practice address
130 W Route 66 Ste 108
Glendora, CA 91740-6250
Phone
(626) 852-8803
Fax
(626) 852-8805
NPI assigned
Mar 24, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT18887 CA Primary

Addresses

Primary practice location

130 W Route 66 Ste 108
Glendora, CA 91740-6250

Mailing address

1230 E Washington St Ste 2
Colton, CA 92324-6438
Phone (909) 825-6716

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1988
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

12015 Hebe Ave
Norwalk, CA 90650-2451

4934 Lankershim Blvd
North Hollywood, CA 91601-4443

PO Box
Suite 530
Simi Valley, CA 93062

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT18887CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Carrera Physical Therapy and Wellness PC Physical Therapist CurrentSince Jun 2, 2026 Accepting new patients
United Therapy Network Inc Physical Therapist Past Accepting new patients
United Therapy Network Incorporated Physical Therapist Past Accepting new patients

Locations

4934 Lankershim Blvd
North Hollywood, CA 91601
Phone (818) 308-7061

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1174694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1316064264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1230 E WASHINGTON ST STE 2",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923246438",
            "telephone_number": "909-825-6716",
            "fax_number": "909-825-4339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 W ROUTE 66 STE 108",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917406250",
            "telephone_number": "626-852-8803",
            "fax_number": "626-852-8805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRERA",
        "first_name": "CARLOS",
        "name_prefix": "Mr.",
        "credential": "PT.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT18887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendora, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.