Active NPI
Gerson Emilio De Leon, P.T
- Physical Therapist
- Ukiah, CA
National Provider Identifier
1790092039
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 36608
- Practice address
- 404 E Perkins St
Ukiah, CA 95482-4507 - Phone
- (707) 874-8180
- NPI assigned
- Sep 8, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 36608 | CA | Primary |
Addresses
Primary practice location
404 E Perkins St
Ukiah, CA 95482-4507
Mailing address
PO Box 785
Ukiah, CA 95482
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 36608 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1283904000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1391731200000",
"number": "1790092039",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 785",
"city": "UKIAH",
"state": "CA",
"postal_code": "95482"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "404 E PERKINS ST",
"city": "UKIAH",
"state": "CA",
"postal_code": "954824507",
"telephone_number": "707-874-8180"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DE LEON",
"first_name": "GERSON",
"middle_name": "EMILIO",
"credential": "P.T",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-09-08",
"last_updated": "2014-02-07",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "36608",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ukiah, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.