Individual provider Active NPI

Daniel Datu Baculi

  • Physical Therapy Assistant
  • Fremont, CA
National Provider Identifier
1700408630
Registry record updated May 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
11206 Issued in CA
Practice address
38660 Lexington St Apt 588
Fremont, CA 94536-6201
Phone
(498) 261-2801
NPI assigned
May 14, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 14, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 11206 CA Primary

Addresses

Primary practice location

38660 Lexington St Apt 588
Fremont, CA 94536-6201

Mailing address

38660 Lexington St Apt 588
Fremont, CA 94536-6201

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

NPI Registry JSON

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

{
    "created_epoch": "1589414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589414400000",
    "number": "1700408630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38660 LEXINGTON ST APT 588",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945366201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38660 LEXINGTON ST APT 588",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945366201",
            "telephone_number": "498-261-2801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACULI",
        "first_name": "DANIEL",
        "middle_name": "DATU",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-05-14",
        "last_updated": "2020-05-14",
        "certification_date": "2020-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": "11206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 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.