Individual provider Active NPI

Paul Steven Chavez, OTR/L

  • Physical Rehabilitation Occupational Therapist
  • Pomona, CA
National Provider Identifier
1790278265
Registry record updated Jun 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Rehabilitation Occupational TherapistTaxonomy code 225XP0019X
License
15127 Issued in CA
Practice address
255 E Bonita Ave
Pomona, CA 91767-1933
Phone
(909) 596-7733
NPI assigned
Jun 10, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Rehabilitation Occupational Therapist 225XP0019X 15127 CA Primary

Addresses

Primary practice location

255 E Bonita Ave
Pomona, CA 91767-1933

Mailing address

11083 San Pasqual Ave
Montclair, CA 91763-6090
Phone (626) 512-9583

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
15127CAMDPhysical Rehabilitation Occupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1528588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528588800000",
    "number": "1790278265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11083 SAN PASQUAL AVE",
            "city": "MONTCLAIR",
            "state": "CA",
            "postal_code": "917636090",
            "telephone_number": "626-512-9583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 E BONITA AVE",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917671933",
            "telephone_number": "909-596-7733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAVEZ",
        "first_name": "PAUL",
        "middle_name": "STEVEN",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-10",
        "last_updated": "2018-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0019X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": "CA",
            "license": "15127",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pomona, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2018; 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.