Active NPI
Marcelino Lacuesta
- Physical Therapy Assistant
- Commerce, CA
National Provider Identifier
1679007884
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- PTA48344
- Practice address
- 6538 Telegraph Rd
Commerce, CA 90040-2518 - Phone
- (562) 726-3212
- Fax
- (562) 726-0942
- NPI assigned
- Apr 13, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | PTA48344 | CA | Primary |
Addresses
Primary practice location
6538 Telegraph Rd
Commerce, CA 90040-2518
Mailing address
7300 Alondra Blvd Ste 101
Paramount, CA 90723-4000
Phone (562) 531-8300
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PTA48344 | CA | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1492041600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1492041600000",
"number": "1679007884",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7300 ALONDRA BLVD STE 101",
"city": "PARAMOUNT",
"state": "CA",
"postal_code": "907234000",
"telephone_number": "562-531-8300",
"fax_number": "562-531-8035"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6538 TELEGRAPH RD",
"city": "COMMERCE",
"state": "CA",
"postal_code": "900402518",
"telephone_number": "562-726-3212",
"fax_number": "562-726-0942"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LACUESTA",
"first_name": "MARCELINO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-04-13",
"last_updated": "2017-04-13",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "CA",
"license": "PTA48344",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Commerce, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.