Dacosta Collymore

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

20709 Issued in CA

Legal business name

DACOSTA COLLYMORE

Practice address

5000 Overland Ave
#4
Culver City, CA 90230

Phone

(310) 836-7650

Fax

(310) 836-7651

NPI assigned

Dec 4, 2007

Organization subpart

No

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

Authorized official

Name

Dacosta Alonzo Collymore, RPT

Title

Ceo Owner

Phone

(310) 836-7650

Specialties & licenses 1

Addresses

Other names 1

• Pacific Rehabilitation Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Te'Nisha Jeanae Washington, DPT

  • Physical Therapist
  • Culver City, CA
  • NPI 1720329279
  NPD (past)

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

{
    "created_epoch": "1196726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214265600000",
    "number": "1609058445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 OVERLAND AVE",
            "address_2": "#4",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "90230",
            "telephone_number": "310-836-7650",
            "fax_number": "310-836-7651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 OVERLAND AVE",
            "address_2": "#4",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "90230",
            "telephone_number": "310-836-7650",
            "fax_number": "310-836-7651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DACOSTA COLLYMORE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-04",
        "last_updated": "2008-06-24",
        "status": "A",
        "authorized_official_last_name": "COLLYMORE",
        "authorized_official_first_name": "DACOSTA",
        "authorized_official_middle_name": "ALONZO",
        "authorized_official_title_or_position": "CEO OWNER",
        "authorized_official_telephone_number": "310-836-7650",
        "authorized_official_credential": "RPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "20709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pacific Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Khashayar Dabbagh
• Andrew Dabbous
• Summer Dabbs
• Aminah Dabdoub
• Tannaz Tani Dabirian, PH.D
• Arnie L Daguil, R.N.
• Qianghui Dai, NURSE PRACTITIONER
• Dakyra Baker
• John S Daley
• Jennifer Dalton

• Physical Therapist in Culver City, CA
• Providers in Culver City, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2008; 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.