NPIMap

Organization Active NPI

Studio Brava Physical Therapy, Inc.

  • Physical Therapy Clinic/Center
  • Los Angeles, CA
National Provider Identifier
1831488527
Registry record updated Nov 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
PT33305 Issued in CA
Legal business name
STUDIO BRAVA PHYSICAL THERAPY, INC.
Practice address
11110 Ohio Ave
# 105
Los Angeles, CA 90025-3388
Phone
(310) 775-1609
Fax
(310) 935-4555
NPI assigned
Apr 1, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2012

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

Authorized official

Name
Miss Cristina Claudia Popescu, PTNPI 1265701353
Title
President
Phone
(310) 775-1609

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X PT33305 CA Primary

Addresses

Primary practice location

11110 Ohio Ave
# 105
Los Angeles, CA 90025-3388

Mailing address

11110 Ohio Ave
# 105
Los Angeles, CA 90025-3388
Phone (310) 775-1609

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120517000376 CA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 1850554429 Receives reassigned benefits from 3 practitioners
Practice locations: Los Angeles, CA

National Provider Directory

National Provider Directory

Locations

11110 Ohio Ave
Ste 105
Los Angeles, CA 90025
Phone (310) 775-1609

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1301616000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352764800000",
    "number": "1831488527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11110 OHIO AVE",
            "address_2": "# 105",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900253388",
            "telephone_number": "310-775-1609",
            "fax_number": "310-935-4555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11110 OHIO AVE",
            "address_2": "# 105",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900253388",
            "telephone_number": "310-775-1609",
            "fax_number": "310-935-4555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STUDIO BRAVA PHYSICAL THERAPY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-01",
        "last_updated": "2012-11-13",
        "status": "A",
        "authorized_official_last_name": "POPESCU",
        "authorized_official_first_name": "CRISTINA",
        "authorized_official_middle_name": "CLAUDIA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-775-1609",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "CA",
            "license": "PT33305",
            "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 Nov 13, 2012; 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.