Mavis Rode Physical Therapy, Inc

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT15928 Issued in CA

Legal business name

MAVIS RODE PHYSICAL THERAPY, INC

Practice address

12425 Brooklake St
Los Angeles, CA 90066-1807

Phone

(310) 397-2740

Fax

(310) 397-2740

NPI assigned

Aug 21, 2013

Last updated

Aug 21, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mavis Rode, DPTNPI 1851314272

Title

President

Phone

(310) 397-2740

Specialties & licenses 1

Addresses

Practitioners 1

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.

• Mavis Rode, DPT

  • Physical Therapist
  • Los Angeles, CA
  • NPI 1851314272
  NPD (past) Authorized official

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

{
    "created_epoch": "1377043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1377043200000",
    "number": "1750715116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12425 BROOKLAKE ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900661807",
            "telephone_number": "310-397-2740",
            "fax_number": "310-397-2740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12425 BROOKLAKE ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900661807",
            "telephone_number": "310-397-2740",
            "fax_number": "310-397-2740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAVIS RODE PHYSICAL THERAPY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-21",
        "last_updated": "2013-08-21",
        "status": "A",
        "authorized_official_last_name": "RODE",
        "authorized_official_first_name": "MAVIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-397-2740",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT15928",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donald Lawrence Mauro, MFC
• Tara Mavadat, DDS
• Mary Maverick, OTR/L
• Mavida Care Group of California PC (Mavida Health Inc.)
• Christine Michelle Mavilian, MS
• Maureen Mavrinac, M.D.
• Jonathan Maw, DO
• Thin Thin Maw, MD
• Vincent Anthony Mawad, PT, DPT
• Yara Salam Mawad, LMFT

• Physical Therapist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2013; 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.