Active NPI
Fabrice M Gautier, RPT
- Physical Therapist
- Beverly Hills, CA
National Provider Identifier
1629131602
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT 27208
- Practice address
- 260 S Beverly Drive #210
Beverly Hills, CA 90212 - Phone
- (310) 273-7660
- Fax
- (310) 273-7661
- NPI assigned
- Dec 19, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT 27208 | CA | Primary |
Addresses
Primary practice location
260 S Beverly Drive #210
Beverly Hills, CA 90212
Mailing address
260 S Beverly Drive #210
Beverly Hills, CA 90212
Phone (310) 273-7660
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| OPT 27208 | Other | CA | BLUE CROSS BLUE SHIELD |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 27208 | CA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166486400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1629131602",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "260 S BEVERLY DRIVE #210",
"city": "BEVERLY HILLS",
"state": "CA",
"postal_code": "90212",
"telephone_number": "310-273-7660",
"fax_number": "310-273-7661"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "260 S BEVERLY DRIVE #210",
"city": "BEVERLY HILLS",
"state": "CA",
"postal_code": "90212",
"telephone_number": "310-273-7660",
"fax_number": "310-273-7661"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAUTIER",
"first_name": "FABRICE",
"middle_name": "M",
"credential": "RPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "PT 27208",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "OPT 27208",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Beverly Hills, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.