Melissa Magdangal, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

20970 Issued in CA

Practice address

2600 Pacific Coast Hwy
Corona del Mar, CA 92625-2117

Phone

(949) 640-2121

NPI assigned

Jun 10, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1591747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616371200000",
    "number": "1467077016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1591 PARADISE CIR",
            "city": "BEAUMONT",
            "state": "CA",
            "postal_code": "922238547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 PACIFIC COAST HWY",
            "city": "CORONA DEL MAR",
            "state": "CA",
            "postal_code": "926252117",
            "telephone_number": "949-640-2121"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2101 N Waterman Ave",
            "address_purpose": "LOCATION",
            "city": "San Bernardino",
            "state": "CA",
            "postal_code": "924044836",
            "country_code": "US",
            "telephone_number": "909-883-8711",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAGDANGAL",
        "first_name": "MELISSA",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-10",
        "last_updated": "2021-03-22",
        "certification_date": "2021-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "20970",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NA",
            "identifier": "NA",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.dignityhealth.org/socal/locations/stbernardinemedical/contact-us",
            "affiliation": "N",
            "address_1": "2101 N Waterman Ave",
            "city": "San Bernardino",
            "state": "CA",
            "country_code": "US",
            "postal_code": "924044836",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Occupational Therapist in Corona del Mar, CA
• Providers in Corona del Mar, CA by specialty
• Occupational Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2021; 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.