NPIMap

Organization Active NPI

Moorpark Physical Therapy & Sport Rehab Center

  • Physical Therapist
  • Moorpark, CA
National Provider Identifier
1730111089
Registry record updated Oct 15, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT19246 Issued in CA
Legal business name
MOORPARK PHYSICAL THERAPY & SPORT REHAB CENTER
Practice address
545 W Los Angeles Ave
Moorpark, CA 93021-1709
Phone
(805) 530-3838
Fax
(805) 530-3832
NPI assigned
Jul 7, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2007

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

Authorized official

Name
Mr. David Michael Faciana, PT, OCS, SCS, CSCS
Title
Owner
Phone
(805) 530-3838

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225100000X PT19246 CA Primary
Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225100000X PT28530 CA
Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225100000X PT24516 CA
Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225100000X PT28978 CA
Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225100000X PT27148 CA

Addresses

Primary practice location

545 W Los Angeles Ave
Moorpark, CA 93021-1709

Mailing address

545 W Los Angeles Ave
Moorpark, CA 93021-1709
Phone (805) 530-3838

National Provider Directory

National Provider Directory

Locations

545 W Los Angeles Ave
Moorpark, CA 93021
Phone (805) 530-3838

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192406400000",
    "number": "1730111089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "545 W LOS ANGELES AVE",
            "city": "MOORPARK",
            "state": "CA",
            "postal_code": "930211709",
            "telephone_number": "805-530-3838",
            "fax_number": "805-530-3832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "545 W LOS ANGELES AVE",
            "city": "MOORPARK",
            "state": "CA",
            "postal_code": "930211709",
            "telephone_number": "805-530-3838",
            "fax_number": "805-530-3832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOORPARK PHYSICAL THERAPY & SPORT REHAB CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-07",
        "last_updated": "2007-10-15",
        "status": "A",
        "authorized_official_last_name": "FACIANA",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "805-530-3838",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT, OCS, SCS, CSCS"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT19246",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT28530",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT24516",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT28978",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT27148",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moorpark, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2007; 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.