Active NPI
Ralph Joseph San Pedro Antonio, RPT
- Physical Therapist
- Long Beach, CA
National Provider Identifier
1487170064
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 293127
- Practice address
- 3605 Long Beach Blvd
Long Beach, CA 90807-4013 - Phone
- (714) 487-1018
- NPI assigned
- Aug 16, 2017
- Last updated
- Aug 16, 2017
- Sex
- Male
- Sole proprietor
- No
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 | 293127 | CA | Primary |
Addresses
Primary practice location
3605 Long Beach Blvd
Long Beach, CA 90807-4013
Mailing address
552 N Dover Rd
Covina, CA 91722-3625
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 293127 | Other | CA | PTBC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1502841600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1502841600000",
"number": "1487170064",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "552 N DOVER RD",
"city": "COVINA",
"state": "CA",
"postal_code": "917223625"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3605 LONG BEACH BLVD",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908074013",
"telephone_number": "714-487-1018"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANTONIO",
"first_name": "RALPH JOSEPH",
"middle_name": "SAN PEDRO",
"credential": "RPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-08-16",
"last_updated": "2017-08-16",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "293127",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PTBC",
"identifier": "293127",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Long Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.