Active NPI
Todd Trujillo, PT
- Physical Therapist
- Tahoe City, CA
National Provider Identifier
1679787014
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 26413
- Practice address
- 705 N Lake Blvd
Box 5591
Tahoe City, CA 96145-5591 - Phone
- (707) 494-6774
- NPI assigned
- May 9, 2007
- 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 Therapist | 225100000X | 26413 | CA | Primary |
Addresses
Primary practice location
705 N Lake Blvd
Box 5591
Tahoe City, CA 96145-5591
Mailing address
705 N Lake Blvd
Box 5591
Tahoe City, CA 96145-5591
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| FN041Z | Other | NV | MEDICARE ID |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26413 | CA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178668800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1423612800000",
"number": "1679787014",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "705 N LAKE BLVD",
"address_2": "BOX 5591",
"city": "TAHOE CITY",
"state": "CA",
"postal_code": "961455591"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "705 N LAKE BLVD",
"address_2": "BOX 5591",
"city": "TAHOE CITY",
"state": "CA",
"postal_code": "961455591",
"telephone_number": "707-494-6774"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRUJILLO",
"first_name": "TODD",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-09",
"last_updated": "2015-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "26413",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE ID",
"identifier": "FN041Z",
"state": "NV"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tahoe City, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.