Individual provider Active NPI

Myreen Q Carreon, RPT

  • Physical Therapist
  • Los Angeles, CA
National Provider Identifier
1518109339
Registry record updated Mar 25, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT34527 Issued in CA
Practice address
2010 Wilshire Blvd
1007
Los Angeles, CA 90057-3507
Phone
(213) 989-0422
NPI assigned
Mar 25, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2009

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 PT34527 CA Primary

Addresses

Primary practice location

2010 Wilshire Blvd
1007
Los Angeles, CA 90057-3507

Mailing address

144 S Kenmore Ave
Los Angeles, CA 90004-5600
Phone (213) 466-1577

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
34527CAMDChiropractor
PT34527CAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1237939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1237939200000",
    "number": "1518109339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "144 S KENMORE AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900045600",
            "telephone_number": "213-466-1577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2010 WILSHIRE BLVD",
            "address_2": "1007",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900573507",
            "telephone_number": "213-989-0422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARREON",
        "first_name": "MYREEN",
        "middle_name": "Q",
        "credential": "RPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-25",
        "last_updated": "2009-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT34527",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Mar 25, 2009; 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.