NPIMap

Organization Active NPI

G3 Physical Therapy and Wellness Center PC

  • Physical Therapist
  • Solana Beach, CA
National Provider Identifier
1669845798
Registry record updated Nov 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
G3 PHYSICAL THERAPY AND WELLNESS CENTER PC
Practice address
740 Lomas Santa Fe Dr Ste 208
Solana Beach, CA 92075-1441
Phone
(760) 452-2640
Fax
(760) 452-2643
NPI assigned
Nov 11, 2015
Last updated
Nov 22, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2022

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

Authorized official

Name
Michael Van Gilder, DPTNPI 1750487690
Title
Owner
Phone
(760) 205-1500

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: 193200000X MULTI-SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

740 Lomas Santa Fe Dr Ste 208
Solana Beach, CA 92075-1441

Mailing address

227 N El Camino Real Ste 100
Suite#100
Encinitas, CA 92024-5821
Phone (760) 205-1500

Other practice location 1

227 N El Camino Real Ste 100
Suite#100
Encinitas, CA 92024-5821
Phone (760) 205-1500

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160118000036 CA Part B Supplier - Clinic/Group Practice 6204139744 Receives reassigned benefits from 16 practitioners
Practice locations: Encinitas, CA; Solana Beach, CA

National Provider Directory

National Provider Directory

Locations

740 Lomas Santa Fe Dr
Ste 208
Solana Beach, CA 92075
Phone (760) 452-2640

Practitioners & affiliated clinicians

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1447200000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669075200000",
    "number": "1669845798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "227 N EL CAMINO REAL STE 100",
            "address_2": "SUITE#100",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920245821",
            "telephone_number": "760-205-1500",
            "fax_number": "760-994-4641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 LOMAS SANTA FE DR STE 208",
            "city": "SOLANA BEACH",
            "state": "CA",
            "postal_code": "920751441",
            "telephone_number": "760-452-2640",
            "fax_number": "760-452-2643"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "227 N El Camino Real Ste 100",
            "address_2": "Suite#100",
            "address_purpose": "LOCATION",
            "city": "Encinitas",
            "state": "CA",
            "postal_code": "920245821",
            "country_code": "US",
            "telephone_number": "760-205-1500",
            "fax_number": "760-994-4641",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "G3 PHYSICAL THERAPY AND WELLNESS CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-11",
        "last_updated": "2022-11-22",
        "certification_date": "2022-11-22",
        "status": "A",
        "authorized_official_last_name": "VAN GILDER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "760-205-1500",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Solana Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2022; 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.