Alan DO Vale Bravo, PT

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

292600 Issued in CA

Practice address

25333 Barton Rd
Loma Linda, CA 92350

Phone

(909) 558-6760

NPI assigned

Jan 9, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1578528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578528000000",
    "number": "1649810425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "249A CRESCENT RD",
            "city": "SAN ANSELMO",
            "state": "CA",
            "postal_code": "949602744",
            "telephone_number": "415-497-8849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25333 BARTON RD",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "92350",
            "telephone_number": "909-558-6760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DO VALE BRAVO",
        "first_name": "ALAN",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-01-09",
        "last_updated": "2020-01-09",
        "certification_date": "2020-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "CA",
            "license": "292600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Devyn Alexandria Diorio
• Divine Home Care
• Ron Kenneth Diwa
• Jacob Kiley Dixon, MD
• Jedediah Dixon, MD
• Catherine Lai DO, MD
• Hieu Duc DO, M.D
• Hyunseon DO, DDS
• Peter Bao DO, D.D.S.
• Ashley Thy Doan

• Physical Therapy Clinic/Center in Loma Linda, CA
• Providers in Loma Linda, CA by specialty
• Physical Therapy Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 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.