Active NPI
Brandon Christopher Marino, RPT
- Physical Therapist
- La Mesa, CA
National Provider Identifier
1841380912
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT25976
- Practice address
- 8939 La Mesa Blvd
Ste 1
La Mesa, CA 91942-9057 - Phone
- (619) 464-1352
- Fax
- (619) 464-7255
- NPI assigned
- Oct 12, 2006
- 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 | PT25976 | CA | Primary |
Addresses
Primary practice location
8939 La Mesa Blvd
Ste 1
La Mesa, CA 91942-9057
Mailing address
8700 Mellmanor Dr
La Mesa, CA 91942-3152
Phone (619) 464-1352
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PT25976 | Other | CA | REG PHYSICAL THERAPIST |
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 |
|---|---|---|---|
| PT25976 | CA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| La Mesa Physical Therapy Group, Inc. | Physical Therapist | Past | Accepting new patients |
| La Mesa Physical Therapy, Inc | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Physical Therapist
- La Mesa, CA
- NPI 1861765190
-
- Physical Therapy Clinic/Center
- La Mesa, CA
- NPI 1790839710
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160611200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1288051200000",
"number": "1841380912",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8700 MELLMANOR DR",
"city": "LA MESA",
"state": "CA",
"postal_code": "919423152",
"telephone_number": "619-464-1352",
"fax_number": "619-464-7255"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8939 LA MESA BLVD",
"address_2": "STE 1",
"city": "LA MESA",
"state": "CA",
"postal_code": "919429057",
"telephone_number": "619-464-1352",
"fax_number": "619-464-7255"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARINO",
"first_name": "BRANDON",
"middle_name": "CHRISTOPHER",
"name_prefix": "Mr.",
"credential": "RPT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-12",
"last_updated": "2010-10-26",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "PT25976",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REG PHYSICAL THERAPIST",
"identifier": "PT25976",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in La Mesa, CA
- Maria I. Frailey, PH.D., a Professional Corporation
- Linda Sippy Maria, P.T.
- Rami Maria, PHARMD
- Aivy Marie Mariano
- Maila Alindog Marinas, NP
- Mario Ammirati M D Inc
- Kerry M Mariota, OTR, CHT
- Mark C Levine MD a Professional Corporation
- Mark Cincotta Chiropractic (San Diego Chiropractic Doctors)
- Robert L Marks, M.D.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.