NPIMap

Organization Active NPI

Mana Mobile Physical Therapy, P.C.

  • Physical Therapist
  • El Segundo, CA
National Provider Identifier
1669085403
Registry record updated Aug 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
MANA MOBILE PHYSICAL THERAPY, P.C.
Practice address
950 Virginia St Apt 102
El Segundo, CA 90245-2170
Phone
(310) 853-3948
NPI assigned
Aug 30, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2020

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

Authorized official

Name
Dr. Garret Lester Wong, PT, DPTNPI 1174840383
Title
President/Physical Therapist
Phone
(310) 853-3948

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 Primary

Addresses

Primary practice location

950 Virginia St Apt 102
El Segundo, CA 90245-2170

Mailing address

950 Virginia St Apt 102
El Segundo, CA 90245-2170
Phone (310) 853-3948

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1598745600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598745600000",
    "number": "1669085403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 VIRGINIA ST APT 102",
            "city": "EL SEGUNDO",
            "state": "CA",
            "postal_code": "902452170",
            "telephone_number": "310-853-3948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 VIRGINIA ST APT 102",
            "city": "EL SEGUNDO",
            "state": "CA",
            "postal_code": "902452170",
            "telephone_number": "310-853-3948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANA MOBILE PHYSICAL THERAPY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-30",
        "last_updated": "2020-08-30",
        "certification_date": "2020-08-30",
        "status": "A",
        "authorized_official_last_name": "WONG",
        "authorized_official_first_name": "GARRET",
        "authorized_official_middle_name": "LESTER",
        "authorized_official_title_or_position": "PRESIDENT/PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "310-853-3948",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Segundo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 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.