NPIMap

Organization Active NPI

Mykl Concepts & Physiotherapy ,PC

  • Physical Therapy Clinic/Center
  • Vista, CA
National Provider Identifier
1891093803
Registry record updated Jul 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
MYKL CONCEPTS & PHYSIOTHERAPY ,PC
Practice address
410 S Melrose Dr Ste 200
Vista, CA 92081-6623
Phone
(858) 229-8178
Fax
(877) 575-2650
NPI assigned
Mar 1, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2020

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

Authorized official

Name
Michael Shannon, PTNPI 1952577983
Title
President
Phone
(858) 229-8178

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 Primary

Addresses

Primary practice location

410 S Melrose Dr Ste 200
Vista, CA 92081-6623

Mailing address

410 S Melrose Dr Ste 200
Vista, CA 92081-6623
Phone (858) 229-8178

National Provider Directory

National Provider Directory

Locations

410 S Melrose Dr
Ste 200
Vista, CA 92081
Phone (760) 630-0683

Practitioners & affiliated clinicians

Practitioners 1

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": "1298937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594944000000",
    "number": "1891093803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 S MELROSE DR STE 200",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920816623",
            "telephone_number": "858-229-8178",
            "fax_number": "877-575-2650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 S MELROSE DR STE 200",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920816623",
            "telephone_number": "858-229-8178",
            "fax_number": "877-575-2650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MYKL CONCEPTS & PHYSIOTHERAPY ,PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-01",
        "last_updated": "2020-07-17",
        "certification_date": "2020-07-17",
        "status": "A",
        "authorized_official_last_name": "SHANNON",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "858-229-8178",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vista, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 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.

Verify at the official NPI Registry.