NPIMap

Organization Active NPI

Ign Physiotherapy Inc

  • Physical Therapist
  • La Verne, CA
National Provider Identifier
1649707464
Registry record updated May 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT33250 Issued in CA
Legal business name
IGN PHYSIOTHERAPY INC
Practice address
2123 Foothill Blvd
Suite D
La Verne, CA 91750-2954
Phone
(818) 415-1522
NPI assigned
May 11, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 11, 2017

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

Authorized official

Name
Mr. Emil Armen NazaryanNPI 1922535731
Title
Clinic Owner
Phone
(818) 415-1522

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X PT33250 CA Primary

Addresses

Primary practice location

2123 Foothill Blvd
Suite D
La Verne, CA 91750-2954

Mailing address

1407 Foothill Blvd
Suite 101
La Verne, CA 91750-3451
Phone (818) 415-1522

Other names 1

  • La Verne Physical Therapy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180207001186 CA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 6103186440 Receives reassigned benefits from 5 practitioners
Practice locations: La Verne, CA

National Provider Directory

National Provider Directory

Locations

2123 Foothill Blvd
Ste D
La Verne, CA 91750
Phone (818) 415-1522

Practitioners & affiliated clinicians

Practitioners 7

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

NPI Registry JSON

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

{
    "created_epoch": "1494460800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1494460800000",
    "number": "1649707464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1407 FOOTHILL BLVD",
            "address_2": "SUITE 101",
            "city": "LA VERNE",
            "state": "CA",
            "postal_code": "917503451",
            "telephone_number": "818-415-1522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2123 FOOTHILL BLVD",
            "address_2": "SUITE D",
            "city": "LA VERNE",
            "state": "CA",
            "postal_code": "917502954",
            "telephone_number": "818-415-1522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IGN PHYSIOTHERAPY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-11",
        "last_updated": "2017-05-11",
        "status": "A",
        "authorized_official_last_name": "NAZARYAN",
        "authorized_official_first_name": "EMIL",
        "authorized_official_middle_name": "ARMEN",
        "authorized_official_title_or_position": "CLINIC OWNER",
        "authorized_official_telephone_number": "818-415-1522",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT33250",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "La Verne Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in La Verne, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.