Organization Active NPI

Socal Therapy Services LLC

  • Sports Medicine (Physical Medicine & Rehabilitation) Physician
  • Anaheim, CA
National Provider Identifier
1477907517
Registry record updated Apr 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081S0010X
Legal business name
SOCAL THERAPY SERVICES LLC
Practice address
1500 S Anaheim Blvd
Suite 160
Anaheim, CA 92805-6242
Phone
(657) 999-5679
NPI assigned
Apr 14, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2016

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

Authorized official

Name
Mr. Jason Aaron Walter David
Title
Member
Phone
(657) 999-5679

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Physical Medicine & Rehabilitation) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2081S0010X Primary

Addresses

Primary practice location

1500 S Anaheim Blvd
Suite 160
Anaheim, CA 92805-6242

Mailing address

1500 S Anaheim Blvd
Suite 160
Anaheim, CA 92805-6242
Phone (657) 999-5679

National Provider Directory

National Provider Directory

Locations

1500 S Anaheim Blvd
Ste 160
Anaheim, CA 92805
Phone (657) 999-5679

NPI Registry JSON

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

{
    "created_epoch": "1460592000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1460592000000",
    "number": "1477907517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 S ANAHEIM BLVD",
            "address_2": "SUITE 160",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928056242",
            "telephone_number": "657-999-5679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 S ANAHEIM BLVD",
            "address_2": "SUITE 160",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928056242",
            "telephone_number": "657-999-5679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOCAL THERAPY SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-14",
        "last_updated": "2016-04-14",
        "status": "A",
        "authorized_official_last_name": "DAVID",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "AARON WALTER",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "657-999-5679",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2081S0010X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2016; 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.