Earl Frank Rebultan, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

9587 Issued in CA

Practice address

11466 Lev Ave
Mission Hills, CA 91345-1229

Phone

(818) 282-0120

NPI assigned

Feb 7, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Earl Rebultan Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: earl.rebultan.p1@direct.lakeside.nextgenshare.com

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

{
    "created_epoch": "1644192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644192000000",
    "number": "1740934967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11466 LEV AVE",
            "city": "MISSION HILLS",
            "state": "CA",
            "postal_code": "913451229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11466 LEV AVE",
            "city": "MISSION HILLS",
            "state": "CA",
            "postal_code": "913451229",
            "telephone_number": "818-282-0120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REBULTAN",
        "first_name": "EARL FRANK",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-02-07",
        "last_updated": "2022-02-07",
        "certification_date": "2022-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": "9587",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EARL",
            "last_name": "REBULTAN",
            "credential": "PTA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Casey Ray, PMHNP
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• Yelena Razgonyayeva, FNP-C
• Donald Rebhun, MD
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• Amel Reguieg, M.D.
• Reliance FB RX LLC
• Remond Nowry Dental Corporation
• Karen G Rentas, PH.D

• Physical Therapy Assistant in Mission Hills, CA
• Providers in Mission Hills, CA by specialty
• Physical Therapy Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2022; 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.