Individual provider Active NPI

Dina Chalom, PT,MOMT

  • Physical Therapist
  • San Diego, CA
National Provider Identifier
1861716482
Registry record updated Jan 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
13277 Issued in CA
Practice address
4241 Jutland Dr Ste 103
San Diego, CA 92117-3697
Phone
(858) 692-8455
NPI assigned
Mar 25, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 25, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 13277 CA Primary
Physical Therapist 225100000X

Addresses

Primary practice location

4241 Jutland Dr Ste 103
San Diego, CA 92117-3697

Mailing address

4241 Jutland Dr Ste 103
San Diego, CA 92117-3697
Phone (858) 692-8455

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

NPI Registry JSON

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

{
    "created_epoch": "1269475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706140800000",
    "number": "1861716482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4241 JUTLAND DR STE 103",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921173697",
            "telephone_number": "858-692-8455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4241 JUTLAND DR STE 103",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921173697",
            "telephone_number": "858-692-8455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHALOM",
        "first_name": "DINA",
        "credential": "PT,MOMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-03-25",
        "last_updated": "2024-01-25",
        "certification_date": "2024-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "13277",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.