Bennett Lavin, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

40818 Issued in CA

Practice address

30141 Antelope Rd
Suite a
Menifee, CA 92584-7001

Phone

(951) 723-1866

Fax

(951) 723-1867

NPI assigned

Dec 9, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• All Star Physical Therapy

  • Physical Therapist
  • Murrieta, CA
  • NPI 1750559431
  NPD (past)

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

{
    "created_epoch": "1386547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393286400000",
    "number": "1427489087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24630 WASHINGTON AVE",
            "address_2": "SUITE 200",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925626131",
            "telephone_number": "951-696-9353",
            "fax_number": "951-973-7216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30141 ANTELOPE RD",
            "address_2": "SUITE A",
            "city": "MENIFEE",
            "state": "CA",
            "postal_code": "925847001",
            "telephone_number": "951-723-1866",
            "fax_number": "951-723-1867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAVIN",
        "first_name": "BENNETT",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-12-09",
        "last_updated": "2014-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "40818",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "CA112199",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Asia Lamb
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• Ruwaichi Sifuel Lauwo, RN
• Jamie Rae Law Suggs, CADCII, MSW
• Michelle Lawantoro, MOT, OTR/L
• Lawrence R. Rouben MD a Professional Medical Corporation
• Lucian Lazureanu, DDS
• Le Dental Group

• Physical Therapist in Menifee, CA
• Providers in Menifee, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2014; 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.