Active NPI
Jesus Enrique Tabares, CMT
- Massage Therapist
- Los Angeles, CA
National Provider Identifier
1841795150
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 75025
- Practice address
- 2333 Beverly Blvd Ste 402-6
Los Angeles, CA 90057-2230 - Phone
- (323) 407-5491
- NPI assigned
- Mar 28, 2018
- 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 |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 75025 | CA | Primary |
Addresses
Primary practice location
2333 Beverly Blvd Ste 402-6
Los Angeles, CA 90057-2230
Mailing address
4423 Loren St
Los Angeles, CA 90063-3223
Phone (323) 407-5491
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
| License | State | Type | Specialty |
|---|---|---|---|
| 75025 | CA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1522195200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1522195200000",
"number": "1841795150",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4423 LOREN ST",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900633223",
"telephone_number": "323-407-5491"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2333 BEVERLY BLVD STE 402-6",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900572230",
"telephone_number": "323-407-5491"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TABARES",
"first_name": "JESUS",
"middle_name": "ENRIQUE",
"credential": "CMT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-03-28",
"last_updated": "2018-03-28",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Massage Therapist",
"state": "CA",
"license": "75025",
"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 Mar 28, 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.