NPIMap

Organization Active NPI

Prodynamics Inc.

Doing business as Titan Physical Therapy and Wellness

  • Physical Therapy Clinic/Center
  • Los Angeles, CA
National Provider Identifier
1437407335
Registry record updated Apr 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
27141 Issued in CA
Legal business name
PRODYNAMICS INC.
Doing business as
Titan Physical Therapy and Wellness
Practice address
12099 W Washington Blvd Ste 408
Los Angeles, CA 90066-2620
Phone
(424) 228-4340
Fax
(424) 228-4109
NPI assigned
Aug 27, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2018

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

Authorized official

Name
Mr. Paul Dawson, PHYSICAL THERAPISTNPI 1720162530
Title
Director
Phone
(424) 228-4340

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 27141 CA Primary
Physical Therapy Clinic/Center 261QP2000X

Addresses

Primary practice location

12099 W Washington Blvd Ste 408
Los Angeles, CA 90066-2620

Mailing address

12099 W Washington Blvd Ste 408
Los Angeles, CA 90066-2620
Phone (424) 228-4340

Other names 1

  • Titan Physical Therapy and Wellness Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180314002040 CA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 2668734476 Receives reassigned benefits from 2 practitioners
Practice locations: Los Angeles, CA

National Provider Directory

National Provider Directory

Locations

12099 W Washington Blvd
Ste 408
Los Angeles, CA 90066
Phone (310) 391-1559

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1346025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1523491200000",
    "number": "1437407335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12099 W WASHINGTON BLVD STE 408",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900662620",
            "telephone_number": "424-228-4340",
            "fax_number": "424-228-4109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12099 W WASHINGTON BLVD STE 408",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900662620",
            "telephone_number": "424-228-4340",
            "fax_number": "424-228-4109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRODYNAMICS INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-27",
        "last_updated": "2018-04-12",
        "status": "A",
        "authorized_official_last_name": "DAWSON",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "424-228-4340",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PHYSICAL THERAPIST"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "CA",
            "license": "27141",
            "primary": true
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Titan Physical Therapy and Wellness",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Titan Physical Therapy and Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Apr 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.