Active NPI
Myreen Q Carreon, RPT
- Physical Therapist
- Los Angeles, CA
National Provider Identifier
1518109339
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT34527
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 34527 | CA | MD | Chiropractor |
| PT34527 | CA | MD | Physical 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.