Active NPI
Mario Gabriel Lopez, DPT
- Physical Therapist
- Pasadena, CA
National Provider Identifier
1417868381
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT307627
- Practice address
- 1015 N Michillinda Ave Apt 202
Pasadena, CA 91107-1922 - Phone
- (909) 282-8376
- NPI assigned
- Sep 16, 2026
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT307627 | CA | Primary |
Addresses
Primary practice location
1015 N Michillinda Ave Apt 202
Pasadena, CA 91107-1922
Mailing address
1015 N Michillinda Ave Apt 202
Pasadena, CA 91107-1922
Phone (909) 282-8376
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1789516800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1789516800000",
"number": "1417868381",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1015 N MICHILLINDA AVE APT 202",
"city": "PASADENA",
"state": "CA",
"postal_code": "911071922",
"telephone_number": "909-282-8376"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1015 N MICHILLINDA AVE APT 202",
"city": "PASADENA",
"state": "CA",
"postal_code": "911071922",
"telephone_number": "909-282-8376"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOPEZ",
"first_name": "MARIO",
"middle_name": "GABRIEL",
"name_prefix": "Dr.",
"credential": "DPT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2026-09-16",
"last_updated": "2026-09-16",
"certification_date": "2026-09-16",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "PT307627",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pasadena, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.