Gary Colletto PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT7597 Issued in CA

Legal business name

GARY COLLETTO PT

Practice address

10605 Balboa Blvd
#240
Granada Hills, CA 91344-6342

Phone

(818) 366-3935

Fax

(818) 368-9351

NPI assigned

Mar 29, 2007

Organization subpart

No

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

Authorized official

Name

Katherine Prentice, PT

Title

PT

Phone

(818) 366-3935

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Colletto Physical Therapy Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Gary D Gray, DO

  • Pediatrics Physician
  • Cedar Rapids, IA
  • NPI 1740267673
  NPD (past)

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1508986233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16692 KNOLLWOOD DR",
            "city": "GRANADA HILLS",
            "state": "CA",
            "postal_code": "913442621",
            "telephone_number": "818-366-3935",
            "fax_number": "818-368-9351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10605 BALBOA BLVD",
            "address_2": "#240",
            "city": "GRANADA HILLS",
            "state": "CA",
            "postal_code": "913446342",
            "telephone_number": "818-366-3935",
            "fax_number": "818-368-9351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARY COLLETTO PT",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PRENTICE",
        "authorized_official_first_name": "KATHERINE",
        "authorized_official_title_or_position": "PT",
        "authorized_official_telephone_number": "818-366-3935",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT7597",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACN GROUP UHC",
            "identifier": "698117",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Colletto Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ximena Garcia
• Garfield Beach CVS LLC
• Garfield Beach CVS LLC
• Garfield Beach CVS LLC
• Norman Espino Garrido
• Gary John Lawson MD a Medical Corporation
• Sirun Gasparyan, PHARMD
• Ann Harding Geller, MA/CCC
• Oleg Geller, ARDMS
• Gems-Tens International

• Physical Therapist in Granada Hills, CA
• Providers in Granada Hills, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.