Elissa R. Rynearson, PT, DPT

Primary specialty

Pediatric Physical TherapistTaxonomy code 2251P0200X

License

PT35066 Issued in CA

Practice address

15805 S Budlong Ave
Gardena, CA 90247-4303

Phone

(310) 327-1758

NPI assigned

Feb 9, 2010

Sex

Female

Sole proprietor

No

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)

Not 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 and National Provider Directory roles.

• Los Angeles County - Gardena Mtu

  • Rehabilitation Clinic/Center
  • Gardena, CA
  • NPI 1689729246
  NPD (past)

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

{
    "created_epoch": "1265673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413504000000",
    "number": "1659603108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20911 CATAMARAN LN",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926465517",
            "telephone_number": "714-595-9246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15805 S BUDLONG AVE",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902474303",
            "telephone_number": "310-327-1758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYNEARSON",
        "first_name": "ELISSA",
        "middle_name": "R.",
        "name_prefix": "Ms.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-09",
        "last_updated": "2014-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "CA",
            "license": "PT35066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ronald Alan Rulison Jr., MSW
• Tony Rushing
• Russell M Gilbertson MD a Professional Corporation
• Jamie D. Russell
• Derian Ruth-Williams
• S. Yousefi Dental Corporation
• Kristin Darlene Saad, FNP
• Magdolin M. Saadalla
• Maria E Saavedra
• Maksida Sabackic, PHARMD

• Pediatric Physical Therapist in Gardena, CA
• Providers in Gardena, CA by specialty
• Pediatric Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2014; 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.