Shogo Takayama

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

11085 Issued in CA

Practice address

6080 Center Dr. 6TH Floor Suite #639
Los Angeles, CA 90045

Phone

(323) 972-7068

NPI assigned

Apr 13, 2023

Last updated

Apr 13, 2023By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1681344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681344000000",
    "number": "1538855580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1309 AMHERST AVE APT 104",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900252030",
            "telephone_number": "323-559-0276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6080 CENTER DR. 6TH FLOOR SUITE #639",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90045",
            "telephone_number": "323-972-7068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAKAYAMA",
        "first_name": "SHOGO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-04-13",
        "last_updated": "2023-04-13",
        "certification_date": "2023-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": "11085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taylor Takasugi, MD
• Yoko Takasumi, MSW
• Glenn Shigeo Takata, MD
• Lauren Grace Takata, PA
• Christian Mario Takayama, M.D.
• Take Care Marriage & Family Therapy, Inc.
• Kristen Takebayashi
• Inette Diana Takeda, M.S.,CCC-SLP
• Akane Takei, LAC
• Cyril Takem Baiyee, M.D

• Physical Therapy Assistant in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Physical Therapy Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2023; 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.