NPIMap

Organization Active NPI

Evolution Physical Therapy, Inc

Doing business as Bebe PT

  • Physical Therapist
  • Los Angeles, CA
National Provider Identifier
1508049099
Registry record updated Dec 7, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
EVOLUTION PHYSICAL THERAPY, INC
Doing business as
Bebe PT
Practice address
11901 Santa Monica Blvd
202
Los Angeles, CA 90025-2767
Phone
(310) 479-2323
NPI assigned
Dec 7, 2007
Last updated
Dec 7, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2007

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

Authorized official

Name
Darwin Fogt, MPT
Title
President
Phone
(310) 305-7100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

11901 Santa Monica Blvd
202
Los Angeles, CA 90025-2767

Mailing address

322 Culver Blvd
207
Playa del Rey, CA 90293-7704
Phone (310) 305-7100

Other names 1

  • Bebe PT Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Bebe PT2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

11901 Santa Monica Blvd
Ste 202
Los Angeles, CA 90025
Phone (301) 341-4885

322 Culver Blvd
Playa del Rey, CA 90293
Phone (310) 779-9712

Practitioners & affiliated clinicians

Practitioners 5

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": "1196985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196985600000",
    "number": "1508049099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "322 CULVER BLVD",
            "address_2": "207",
            "city": "PLAYA DEL REY",
            "state": "CA",
            "postal_code": "902937704",
            "telephone_number": "310-305-7100",
            "fax_number": "310-305-7101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11901 SANTA MONICA BLVD",
            "address_2": "202",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900252767",
            "telephone_number": "310-479-2323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVOLUTION PHYSICAL THERAPY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-07",
        "last_updated": "2007-12-07",
        "status": "A",
        "authorized_official_last_name": "FOGT",
        "authorized_official_first_name": "DARWIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-305-7100",
        "authorized_official_credential": "MPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bebe PT",
            "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 Dec 7, 2007; 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.