Active NPI
Victor Oberneder, P.T.
- Physical Therapist
- Big Bear Lake, CA
National Provider Identifier
1891801577
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 9625
- Practice address
- 41945 Big Bear Blvd
209
Big Bear Lake, CA 92315-2827 - Phone
- (909) 866-6200
- Fax
- (909) 866-6111
- NPI assigned
- Aug 22, 2006
- Sex
- Male
- Sole proprietor
- No
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 | 9625 | CA | Primary |
Addresses
Primary practice location
41945 Big Bear Blvd
209
Big Bear Lake, CA 92315-2827
Mailing address
PO Box 2827
Big Bear Lake, CA 92315-2827
Phone (909) 866-6200
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 |
|---|---|---|---|
| 9625 | CA | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Matrix Rehabilitation, Inc. | Past | Accepting new patients |
Organizations & group practices 1
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 Therapy Clinic/Center
- San Diego, CA
- NPI 1730124116
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156204800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1891801577",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2827",
"city": "BIG BEAR LAKE",
"state": "CA",
"postal_code": "923152827",
"telephone_number": "909-866-6200",
"fax_number": "909-866-6111"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "41945 BIG BEAR BLVD",
"address_2": "209",
"city": "BIG BEAR LAKE",
"state": "CA",
"postal_code": "923152827",
"telephone_number": "909-866-6200",
"fax_number": "909-866-6111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OBERNEDER",
"first_name": "VICTOR",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "9625",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Big Bear Lake, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.