Active NPI
John Carlo Tolentino Montecillo
- Physical Therapist
- Winnetka, CA
National Provider Identifier
1326401779
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 40178
- Practice address
- 20260 Mobile St
Winnetka, CA 91306-4241 - Phone
- (818) 687-2071
- NPI assigned
- Apr 2, 2016
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 40178 | CA | Primary |
Addresses
Primary practice location
20260 Mobile St
Winnetka, CA 91306-4241
Mailing address
20260 Mobile St
Winnetka, CA 91306-4241
Phone (818) 687-2071
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 |
|---|---|---|---|
| 40178 | CA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1459555200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1728172800000",
"number": "1326401779",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20260 MOBILE ST",
"city": "WINNETKA",
"state": "CA",
"postal_code": "913064241",
"telephone_number": "818-687-2071"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20260 MOBILE ST",
"city": "WINNETKA",
"state": "CA",
"postal_code": "913064241",
"telephone_number": "818-687-2071"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MONTECILLO",
"first_name": "JOHN CARLO",
"middle_name": "TOLENTINO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-04-02",
"last_updated": "2024-10-06",
"certification_date": "2024-10-06",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "40178",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Winnetka, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.