NPIMap

Organization Active NPI

Total Care Physical Therapy Inc.

  • Physical Therapy Clinic/Center
  • Colton, CA
National Provider Identifier
1831441054
Registry record updated Dec 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
29866 Issued in CA
Legal business name
TOTAL CARE PHYSICAL THERAPY INC.
Practice address
930 S Mount Vernon Ave Ste 400
Colton, CA 92324-3928
Phone
(909) 370-3396
Fax
(909) 883-5473
NPI assigned
Oct 11, 2012
Last updated
Dec 6, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2019

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

Authorized official

Name
Myungjin Kim, PT., MANPI 1578861399
Title
PT/Ceo
Phone
(909) 370-3396

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Hearing and Speech Clinic/Center 261QH0700X
Physical Therapy Clinic/Center 261QP2000X 29866 CA Primary
Occupational Medicine Clinic/Center 261QX0100X

Addresses

Primary practice location

930 S Mount Vernon Ave Ste 400
Colton, CA 92324-3928

Mailing address

PO Box 10016
Redlands, CA 92375-3216
Phone (909) 370-3396

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20131017001909 CA Part B Supplier - Clinic/Group Practice 9830341767 Receives reassigned benefits from 7 practitioners
Practice locations: Grand Terrace, CA; Redlands, CA; San Bernardino, CA

National Provider Directory

National Provider Directory

Locations

930 S Mount Vernon Ave
Ste 400
Colton, CA 92324
Phone (909) 370-3396

1323 W Colton Ave
Ste 105
Redlands, CA 92374
Phone (909) 883-5069

1181 E Highland Ave
#B
San Bernardino, CA 92404
Phone (909) 883-5069

2288 N Sierra Way
Sn Bernrdno, CA 92405
Phone (909) 475-8724

Practitioners & affiliated clinicians

Practitioners 22

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.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1349913600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1575590400000",
    "number": "1831441054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10016",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923753216",
            "telephone_number": "909-370-3396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 S MOUNT VERNON AVE STE 400",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923243928",
            "telephone_number": "909-370-3396",
            "fax_number": "909-883-5473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOTAL CARE PHYSICAL THERAPY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-11",
        "last_updated": "2019-12-06",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "MYUNGJIN",
        "authorized_official_title_or_position": "PT/CEO",
        "authorized_official_telephone_number": "909-370-3396",
        "authorized_official_credential": "PT., MA"
    },
    "taxonomies": [
        {
            "code": "261QH0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Hearing and Speech",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "CA",
            "license": "29866",
            "primary": true
        },
        {
            "code": "261QX0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Occupational Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2019; 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.