Individual provider Active NPI

King Esteban Antonio, PT

  • Physical Therapist
  • Woodland Hills, CA
National Provider Identifier
1407601024
Registry record updated Apr 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT29908 Issued in CA
Practice address
5510 Owensmouth Ave Apt 131
Woodland Hills, CA 91367-7079
Phone
(818) 268-4548
NPI assigned
Apr 18, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT29908 CA Primary

Addresses

Primary practice location

5510 Owensmouth Ave Apt 131
Woodland Hills, CA 91367-7079

Mailing address

5510 Owensmouth Ave Apt 131
Woodland Hills, CA 91367-7079
Phone (818) 268-4548

Other names 1

  • Enrique Esteban Antonio Former name

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

LicenseStateTypeSpecialty
PT29908CAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1713398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713398400000",
    "number": "1407601024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5510 OWENSMOUTH AVE APT 131",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913677079",
            "telephone_number": "818-268-4548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5510 OWENSMOUTH AVE APT 131",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913677079",
            "telephone_number": "818-268-4548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTONIO",
        "first_name": "KING",
        "middle_name": "ESTEBAN",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-04-18",
        "last_updated": "2024-04-18",
        "certification_date": "2024-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT29908",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ENRIQUE",
            "last_name": "ANTONIO",
            "middle_name": "ESTEBAN",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Woodland Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 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.

Verify at the official NPI Registry.