Active NPI
Gerald Solberg, PHYSICAL THERAPIST
- Physical Therapist
- Stockton, CA
National Provider Identifier
1386973915
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT 5818
- Practice address
- 534 E Pine St Ste a
Stockton, CA 95204-5536 - Phone
- (209) 463-5800
- Fax
- (209) 463-5900
- NPI assigned
- Dec 10, 2009
- 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 | PT 5818 | CA | Primary |
Addresses
Primary practice location
534 E Pine St Ste a
Stockton, CA 95204-5536
Mailing address
534 E Pine St Ste a
Stockton, CA 95204-5536
Phone (209) 463-5800
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PT5818 | Other | CA | STATE PT LICENSE |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5818 | CA | MD | Speech-Language Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1260403200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1260403200000",
"number": "1386973915",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "534 E PINE ST STE A",
"city": "STOCKTON",
"state": "CA",
"postal_code": "952045536",
"telephone_number": "209-463-5800",
"fax_number": "209-463-5900"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "534 E PINE ST STE A",
"city": "STOCKTON",
"state": "CA",
"postal_code": "952045536",
"telephone_number": "209-463-5800",
"fax_number": "209-463-5900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOLBERG",
"first_name": "GERALD",
"name_prefix": "Mr.",
"credential": "PHYSICAL THERAPIST",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-12-10",
"last_updated": "2009-12-10",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "PT 5818",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE PT LICENSE",
"identifier": "PT5818",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Stockton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.