Individual provider Active NPI

Evan Pierce Leith, P.T

  • Physical Therapy Assistant
  • Santa Monica, CA
National Provider Identifier
1558713271
Registry record updated Jul 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
48024 Issued in CA
Practice address
427 Wilshire Blvd
Santa Monica, CA 90401-1409
Phone
(310) 656-8600
Fax
(310) 656-8606
NPI assigned
Jul 6, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 48024 CA Primary

Addresses

Primary practice location

427 Wilshire Blvd
Santa Monica, CA 90401-1409

Mailing address

2208 W 8TH St Apt 225
Los Angeles, CA 90057-5046
Phone (424) 400-4671

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
48024CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1467763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467763200000",
    "number": "1558713271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2208 W 8TH ST APT 225",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900575046",
            "telephone_number": "424-400-4671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "427 WILSHIRE BLVD",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904011409",
            "telephone_number": "310-656-8600",
            "fax_number": "310-656-8606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEITH",
        "first_name": "EVAN",
        "middle_name": "PIERCE",
        "credential": "P.T",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-06",
        "last_updated": "2016-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": "48024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2016; 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.