NPIMap

Organization Active NPI

Anthony Wallace

Doing business as Paso Robles Physical Therapy

  • Physical Therapist
  • Paso Robles, CA
National Provider Identifier
1720086838
Registry record updated May 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT 10294 Issued in CA
Legal business name
ANTHONY WALLACE
Doing business as
Paso Robles Physical Therapy
Practice address
1414 Park St
Paso Robles, CA 93446-2160
Phone
(805) 237-0272
Fax
(805) 237-2416
NPI assigned
Jul 12, 2005
Last updated
May 9, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 9, 2018

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

Authorized official

Name
Mr. Anthony Paul Wallace, PTNPI 1891793923
Title
Owner
Phone
(805) 237-0272

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT 10294 CA Primary

Addresses

Primary practice location

1414 Park St
Paso Robles, CA 93446-2160

Mailing address

5255 El Camino Real Ste C
Atascadero, CA 93422-3351
Phone (805) 237-0272

Other names 1

  • Paso Robles Physical Therapy Doing business as

National Provider Directory

National Provider Directory

Locations

3520 Combine St
Paso Robles, CA 93446
Phone (805) 237-0272

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1121126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1525824000000",
    "number": "1720086838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5255 EL CAMINO REAL STE C",
            "city": "ATASCADERO",
            "state": "CA",
            "postal_code": "934223351",
            "telephone_number": "805-237-0272",
            "fax_number": "805-237-2416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 PARK ST",
            "city": "PASO ROBLES",
            "state": "CA",
            "postal_code": "934462160",
            "telephone_number": "805-237-0272",
            "fax_number": "805-237-2416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANTHONY WALLACE",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-12",
        "last_updated": "2018-05-09",
        "status": "A",
        "authorized_official_last_name": "WALLACE",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "805-237-0272",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT 10294",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Paso Robles Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Paso Robles Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Paso Robles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 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.