Ian K Wallsh, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

34642 Issued in CA

Practice address

704 N Irena Ave Unit B
Redondo Beach, CA 90277-2217

Phone

(310) 379-2926

NPI assigned

Jun 4, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• California Luna Care Physical Therapy PC

  • Physical Therapist
  • Los Gatos, CA
  • NPI 1689162166
  Medicare reassignment NPD
• Torrance Health Association Inc

  • Family Medicine Physician
  • Torrance, CA
  • NPI 1083903124
  Medicare reassignment

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

{
    "created_epoch": "1212537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562112000000",
    "number": "1538328539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "704 NORTH IRENA AVE UNIT B",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902772217",
            "telephone_number": "310-379-2926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "704 N IRENA AVE UNIT B",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902772217",
            "telephone_number": "310-379-2926"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "68 Willow Rd",
            "address_purpose": "LOCATION",
            "city": "Menlo Park",
            "state": "CA",
            "postal_code": "940253653",
            "country_code": "US",
            "telephone_number": "866-839-6979",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALLSH",
        "first_name": "IAN",
        "middle_name": "K",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-04",
        "last_updated": "2019-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "34642",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jolee Walker, M.A., LMFT
• Celeste Orozco Wallace
• Jennifer Marie Wallace, L.A.C
• David Wallis, MD
• Robert Walls, RN, ATC,CES,PES,FRC
• Adam Walsh
• Amanda Victoria Walsh
• Gerald Walsh
• Rodman D Walsh, LMFT
• Shelby Walton

• Physical Therapist in Redondo Beach, CA
• Providers in Redondo Beach, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.