Active NPI
Mike Powell, P.T.
- Physical Therapist
- Long Beach, CA
National Provider Identifier
1326297599
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 34722
- Practice address
- 2017 Palo Verde Ave
Long Beach, CA 90815-3300 - Phone
- (562) 493-5501
- NPI assigned
- Sep 12, 2008
- Last updated
- Sep 12, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 34722 | CA | Primary |
Addresses
Primary practice location
2017 Palo Verde Ave
Long Beach, CA 90815-3300
Mailing address
1940 Marker Ave
Long Beach, CA 90815
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
| License | State | Type | Specialty |
|---|---|---|---|
| 34722 | CA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1221177600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1221177600000",
"number": "1326297599",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1940 MARKER AVE",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "90815"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2017 PALO VERDE AVE",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908153300",
"telephone_number": "562-493-5501"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POWELL",
"first_name": "MIKE",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-09-12",
"last_updated": "2008-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "34722",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Long Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 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.