Joshua Bader

Key facts

NPI

1649794850

Entity type

Individual (NPI type 1)

Primary specialty

Physical Therapist 225100000X

Practice address

801 Traeger Ave Ste 212
San Bruno, CA 94066-3048

Phone

(650) 742-7110

NPI assigned

Jul 29, 2017

Sex

Male

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

Yes

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 21, 2022.

{
    "created_epoch": "1501286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1649794850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "685 FREDERICK ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941172709",
            "telephone_number": "415-244-3909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 TRAEGER AVE STE 212",
            "city": "SAN BRUNO",
            "state": "CA",
            "postal_code": "940663048",
            "telephone_number": "650-742-7110"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "685 Frederick St",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941172709",
            "country_code": "US",
            "telephone_number": "415-244-3909",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BADER",
        "first_name": "JOSHUA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-29",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in San Bruno, CA · Physical Therapist in California