Individual provider Active NPI

Roger Gurdian

  • Massage Therapist
  • Laguna Hills, CA
National Provider Identifier
1780040048
Registry record updated Jan 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
53121 Issued in CA
Practice address
25431 Cabot Rd Ste 207
Laguna Hills, CA 92653-5527
Phone
(310) 803-3283
NPI assigned
Jan 1, 2016
Last updated
Jan 1, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 1, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 53121 CA Primary
Massage Therapist 225700000X MA 64186 FL

Addresses

Primary practice location

25431 Cabot Rd Ste 207
Laguna Hills, CA 92653-5527

Mailing address

22771 Via Santiago
Mission Viejo, CA 92691-2129
Phone (310) 803-3283

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
53121CAMDMassage Therapist
MA 64186FLMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1451606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451606400000",
    "number": "1780040048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22771 VIA SANTIAGO",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926912129",
            "telephone_number": "310-803-3283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25431 CABOT RD STE 207",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926535527",
            "telephone_number": "310-803-3283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GURDIAN",
        "first_name": "ROGER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-01-01",
        "last_updated": "2016-01-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "CA",
            "license": "53121",
            "primary": true
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "FL",
            "license": "MA 64186",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laguna Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 1, 2016; 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.