LB Physical Therapy PC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT13316 Issued in CA

Legal business name

LB PHYSICAL THERAPY PC

Practice address

820 2ND St
Los Banos, CA 93635-4124

Phone

(209) 826-8623

Fax

(209) 826-1433

NPI assigned

Jun 11, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Malcolm Daniel Nation, PT

Title

President/PT

Phone

(209) 826-8623

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1149984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695081600000",
    "number": "1356383913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 2ND ST",
            "city": "LOS BANOS",
            "state": "CA",
            "postal_code": "936354124",
            "telephone_number": "209-826-8623",
            "fax_number": "209-826-1433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 2ND ST",
            "city": "LOS BANOS",
            "state": "CA",
            "postal_code": "936354124",
            "telephone_number": "209-826-8623",
            "fax_number": "209-826-1433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LB PHYSICAL THERAPY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-11",
        "last_updated": "2023-09-19",
        "certification_date": "2022-08-03",
        "status": "A",
        "authorized_official_last_name": "NATION",
        "authorized_official_first_name": "MALCOLM",
        "authorized_official_middle_name": "DANIEL",
        "authorized_official_title_or_position": "PRESIDENT/PT",
        "authorized_official_telephone_number": "209-826-8623",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT13316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Los Banos, CA
• Providers in Los Banos, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2023; 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.