Individual provider Active NPI

Erik Fernando Trujillo, PTA

  • Physical Therapy Assistant
  • La Mirada, CA
National Provider Identifier
1639780257
Registry record updated Aug 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
49218 Issued in CA
Practice address
11926 La Mirada Blvd
La Mirada, CA 90638-1303
Phone
(562) 943-7156
NPI assigned
Aug 17, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 17, 2020

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 49218 CA Primary

Addresses

Primary practice location

11926 La Mirada Blvd
La Mirada, CA 90638-1303

Mailing address

6809 Glengarry Ave
Whittier, CA 90606-1628
Phone (562) 879-3745

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
49218CAMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1597622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597622400000",
    "number": "1639780257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6809 GLENGARRY AVE",
            "city": "WHITTIER",
            "state": "CA",
            "postal_code": "906061628",
            "telephone_number": "562-879-3745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11926 LA MIRADA BLVD",
            "city": "LA MIRADA",
            "state": "CA",
            "postal_code": "906381303",
            "telephone_number": "562-943-7156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRUJILLO",
        "first_name": "ERIK",
        "middle_name": "FERNANDO",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-08-17",
        "last_updated": "2020-08-17",
        "certification_date": "2020-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": "49218",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Mirada, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2020; 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.