Individual provider Active NPI

Harvey Abonales, PT

  • Physical Therapist
  • San Bernardino, CA
National Provider Identifier
1679058648
Registry record updated Sep 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
39057 Issued in CA
Practice address
410 E Parkcenter Cir N
San Bernardino, CA 92408-2869
Phone
(909) 314-3367
NPI assigned
Sep 26, 2018
Last updated
Sep 26, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 39057 CA Primary

Addresses

Primary practice location

410 E Parkcenter Cir N
San Bernardino, CA 92408-2869

Mailing address

410 E Parkcenter Cir N
San Bernardino, CA 92408-2869
Phone (909) 314-3367

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

LicenseStateTypeSpecialty
39057CAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1537920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537920000000",
    "number": "1679058648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 E PARKCENTER CIR N",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924082869",
            "telephone_number": "909-314-3367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 E PARKCENTER CIR N",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924082869",
            "telephone_number": "909-314-3367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABONALES",
        "first_name": "HARVEY",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-26",
        "last_updated": "2018-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "39057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2018; 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.