Active NPI
Gloria Vivian Castellanos, PT
- Physical Therapist
- Los Angeles, CA
National Provider Identifier
1376750190
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 13304
- Practice address
- 1200 N State St
Los Angeles, CA 90033-1029 - Phone
- (323) 226-7286
- Fax
- (323) 226-7288
- NPI assigned
- May 17, 2007
- Sex
- Female
- 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 | 13304 | CA | Primary |
Addresses
Primary practice location
1200 N State St
Los Angeles, CA 90033-1029
Mailing address
1660 Maltman Ave
Los Angeles, CA 90026-1022
Phone (323) 666-8175
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 |
|---|---|---|---|
| 13304 | CA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179360000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1376750190",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1660 MALTMAN AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900261022",
"telephone_number": "323-666-8175"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1200 N STATE ST",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900331029",
"telephone_number": "323-226-7286",
"fax_number": "323-226-7288"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CASTELLANOS",
"first_name": "GLORIA",
"middle_name": "VIVIAN",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-17",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "13304",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.