Active NPI
Winright Dominic Tan, OT
- Occupational Therapist
- Los Angeles, CA
National Provider Identifier
1407988959
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT9459
- Practice address
- 8167 W 3Rd St
Los Angeles, CA 90048-4314 - Phone
- (323) 655-2023
- NPI assigned
- Mar 11, 2007
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OT9459 | CA | Primary |
Addresses
Primary practice location
8167 W 3Rd St
Los Angeles, CA 90048-4314
Mailing address
8167 W 3Rd St.
Los Angeles, CA 90048
Phone (323) 655-2023
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 |
|---|---|---|---|
| OT9459 | CA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173571200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1423526400000",
"number": "1407988959",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8167 W 3RD ST.",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "90048",
"telephone_number": "323-655-2023"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8167 W 3RD ST",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900484314",
"telephone_number": "323-655-2023"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAN",
"first_name": "WINRIGHT",
"middle_name": "DOMINIC",
"credential": "OT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-11",
"last_updated": "2015-02-10",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CA",
"license": "OT9459",
"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 Feb 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.