Individual provider Active NPI

Charles Joseph Marty, P.T.

  • Orthopedic Physical Therapist
  • San Diego, CA
National Provider Identifier
1598083933
Registry record updated May 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
PT8081 Issued in CA
Practice address
3666 Kearny Villa Rd
200
San Diego, CA 92123-1951
Phone
(858) 505-5400
Fax
(858) 505-5459
NPI assigned
May 10, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physical Therapist 2251S0007X PT8081 CA
Orthopedic Physical Therapist 2251X0800X PT8081 CA Primary

Addresses

Primary practice location

3666 Kearny Villa Rd
200
San Diego, CA 92123-1951

Mailing address

3666 Kearny Villa Rd
200
San Diego, CA 92123-1951
Phone (858) 505-5400

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
PT8081CAMDOrthopedic Physical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1273449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1273449600000",
    "number": "1598083933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3666 KEARNY VILLA RD",
            "address_2": "200",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231951",
            "telephone_number": "858-505-5400",
            "fax_number": "858-505-5459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3666 KEARNY VILLA RD",
            "address_2": "200",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231951",
            "telephone_number": "858-505-5400",
            "fax_number": "858-505-5459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTY",
        "first_name": "CHARLES",
        "middle_name": "JOSEPH",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-10",
        "last_updated": "2010-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": "CA",
            "license": "PT8081",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CA",
            "license": "PT8081",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2010; 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.