Individual provider Active NPI

Anthony Michael Pandes Dato-on, DPT

  • Physical Therapist
  • Culver City, CA
National Provider Identifier
1710393244
Registry record updated Jul 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
41386 Issued in CA
Practice address
11825 Major St
Penthouse Suite
Culver City, CA 90230-6356
Phone
(310) 915-6100
NPI assigned
Jul 4, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 4, 2014

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 41386 CA Primary

Addresses

Primary practice location

11825 Major St
Penthouse Suite
Culver City, CA 90230-6356

Mailing address

7301 W Manchester Ave
Unit 104
Los Angeles, CA 90045-2395
Phone (949) 702-2074

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

LicenseStateTypeSpecialty
41386CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Next Phase Medical PC PastSince Sep 28, 2025 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1404432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404432000000",
    "number": "1710393244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7301 W MANCHESTER AVE",
            "address_2": "UNIT 104",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900452395",
            "telephone_number": "949-702-2074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11825 MAJOR ST",
            "address_2": "PENTHOUSE SUITE",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902306356",
            "telephone_number": "310-915-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DATO-ON",
        "first_name": "ANTHONY MICHAEL",
        "middle_name": "PANDES",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-04",
        "last_updated": "2014-07-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "41386",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Culver City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 4, 2014; 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.