Active NPI
David Dellaserra
- Physical Therapist
- Temecula, CA
National Provider Identifier
1841898624
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT298897
- Practice address
- 27699 Jefferson Ave Ste 202
Temecula, CA 92590-2697 - Phone
- (951) 506-1405
- NPI assigned
- Oct 13, 2020
- Last updated
- Oct 13, 2020
- 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 | PT298897 | CA | Primary |
Addresses
Primary practice location
27699 Jefferson Ave Ste 202
Temecula, CA 92590-2697
Mailing address
10649 Granby Way
San Diego, CA 92126-5918
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 |
|---|---|---|---|
| PT298897 | CA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1602547200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1602547200000",
"number": "1841898624",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10649 GRANBY WAY",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921265918"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "27699 JEFFERSON AVE STE 202",
"city": "TEMECULA",
"state": "CA",
"postal_code": "925902697",
"telephone_number": "951-506-1405"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DELLASERRA",
"first_name": "DAVID",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-10-13",
"last_updated": "2020-10-13",
"certification_date": "2020-10-13",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "PT298897",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Temecula, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.