Individual provider Active NPI

Mark Darnold Cagampang Mayol

  • Physical Therapist
  • Pasadena, CA
National Provider Identifier
1508251836
Registry record updated Apr 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
037670 Issued in NY
Practice address
63 S Parkwood Ave
Apt 4
Pasadena, CA 91107-3538
Phone
(626) 298-0603
NPI assigned
Apr 2, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 037670 NY Primary

Addresses

Primary practice location

63 S Parkwood Ave
Apt 4
Pasadena, CA 91107-3538

Mailing address

1724 E Woodbury Rd
Pasadena, CA 91104-1539
Phone (626) 298-0603

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

State licenses

LicenseStateTypeSpecialty
037670NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1427932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427932800000",
    "number": "1508251836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1724 E WOODBURY RD",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911041539",
            "telephone_number": "626-298-0603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "63 S PARKWOOD AVE",
            "address_2": "APT 4",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911073538",
            "telephone_number": "626-298-0603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYOL",
        "first_name": "MARK DARNOLD",
        "middle_name": "CAGAMPANG",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-02",
        "last_updated": "2015-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "037670",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2015; 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.