Organization Active NPI

Paulseth and Associates Physical Therapy Inc.

  • Physical Therapist
  • Los Angeles, CA
National Provider Identifier
1760580351
Registry record updated Feb 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
PAULSETH AND ASSOCIATES PHYSICAL THERAPY INC.
Practice address
10351 Santa Monica Blvd Ste 101
Los Angeles, CA 90025-6943
Phone
(310) 286-0447
Fax
(310) 286-0447
NPI assigned
Sep 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2024

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

Authorized official

Name
Bobby Ismail
Title
President
Phone
(209) 353-1988

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

10351 Santa Monica Blvd Ste 101
Los Angeles, CA 90025-6943

Mailing address

10351 Santa Monica Blvd Ste 101
Los Angeles, CA 90025-6943
Phone (310) 286-0447

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031126000770 CA Part B Supplier - Clinic/Group Practice 9638074073 Receives reassigned benefits from 6 practitioners
Practice locations: Los Angeles, CA

National Provider Directory

National Provider Directory

Locations

1914 S Bundy Dr
Los Angeles, CA 90025
Phone (310) 286-0447

12100 W Olympic Blvd
Los Angeles, CA 90064
Phone (310) 286-0447

Practitioners & affiliated clinicians

Practitioners 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708300800000",
    "number": "1760580351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10351 SANTA MONICA BLVD STE 101",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900256943",
            "telephone_number": "310-286-0447",
            "fax_number": "310-286-1224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10351 SANTA MONICA BLVD STE 101",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900256943",
            "telephone_number": "310-286-0447",
            "fax_number": "310-286-0447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAULSETH AND ASSOCIATES PHYSICAL THERAPY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2024-02-19",
        "certification_date": "2024-02-19",
        "status": "A",
        "authorized_official_last_name": "ISMAIL",
        "authorized_official_first_name": "BOBBY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "209-353-1988"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.