Emmanuel Eli Maldonado, CMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

52278 Issued in CA

Practice address

11461 W Washington Blvd Ste 1
Los Angeles, CA 90066-6026

Phone

(424) 543-4336

NPI assigned

Sep 25, 2023

Last updated

Sep 25, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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

• Victory Performance and Physical Therapy

  • Orthopedic Physical Therapist
  • Los Angeles, CA
  • NPI 1609393396
  NPD (past)

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

{
    "created_epoch": "1695600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695600000000",
    "number": "1487433058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20107 LIVORNO WAY",
            "city": "PORTER RANCH",
            "state": "CA",
            "postal_code": "913264090",
            "telephone_number": "818-371-4997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11461 W WASHINGTON BLVD STE 1",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900666026",
            "telephone_number": "424-543-4336"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20107 Livorno Way",
            "address_purpose": "LOCATION",
            "city": "Porter Ranch",
            "state": "CA",
            "postal_code": "913264090",
            "country_code": "US",
            "telephone_number": "818-371-4997",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MALDONADO",
        "first_name": "EMMANUEL",
        "middle_name": "ELI",
        "credential": "CMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-09-25",
        "last_updated": "2023-09-25",
        "certification_date": "2023-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "CA",
            "license": "52278",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adilene Maldonado
• Angie Michelle Maldonado, BA
• Arnaldo Maldonado
• Daniel Carrillo Maldonado, M.D.
• Elena B. Maldonado
• Ernesto Maldonado
• Fatima Maldonado
• Gabriela Maldonado
• Georgina Maldonado
• Irma Maldonado

• Massage Therapist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Massage Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2023; 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.