Maria Consuelo Bontuyan Padal, PT

Primary specialty

Geriatric Physical TherapistTaxonomy code 2251G0304X

License

PT29476 Issued in CA

Practice address

8121 Van Nuys Blvd Ste 510
Panorama City, CA 91402-5130

Phone

(818) 392-8115

NPI assigned

Jan 17, 2008

Last updated

Dec 1, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• California Rehab Group

  • Geriatric Physical Therapist
  • North Hollywood, CA
  • NPI 1376566711

  Geriatrics

  NPD (past)

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

{
    "created_epoch": "1200528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638316800000",
    "number": "1629254966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8121 VAN NUYS BLVD STE 510",
            "city": "PANORAMA CITY",
            "state": "CA",
            "postal_code": "914025130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8121 VAN NUYS BLVD STE 510",
            "city": "PANORAMA CITY",
            "state": "CA",
            "postal_code": "914025130",
            "telephone_number": "818-392-8115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PADAL",
        "first_name": "MARIA CONSUELO",
        "middle_name": "BONTUYAN",
        "name_prefix": "Miss",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-01-17",
        "last_updated": "2021-12-01",
        "certification_date": "2021-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251G0304X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Geriatrics",
            "state": "CA",
            "license": "PT29476",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICARE PTAN",
            "identifier": "W20102A",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "6041 Cadillac Ave",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900341702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Nancy Ozuna, LVN
• Jacqueline G. Pachon, MD
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• Pacifica Fortuna Inc (Pacifica Fortuna Pharmacy)
• Arvi Jaugan Pacoy, NP-C
• Kristine Cachola Padilla, M.D.
• Sheila Kay Najarilla Padre
• Megan Pagan
• Eugene Pahk
• Elian Daniel Paiuk, MD

• Geriatric Physical Therapist in Panorama City, CA
• Providers in Panorama City, CA by specialty
• Geriatric Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2021; 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.