Individual provider Active NPI

Robert (None) Marrujo, PT

  • Physical Therapist
  • San Diego, CA
National Provider Identifier
1902010366
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT13093 Issued in CA
Practice address
5782 Hughes St
San Diego, CA 92115-6515
Phone
(619) 750-8393
Fax
(619) 286-3478
NPI assigned
May 9, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT13093 CA Primary

Addresses

Primary practice location

5782 Hughes St
San Diego, CA 92115-6515

Mailing address

5782 Hughes St
San Diego, CA 92115-6515
Phone (619) 750-8393

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": "1178668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1902010366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5782 HUGHES ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921156515",
            "telephone_number": "619-750-8393",
            "fax_number": "619-286-3478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5782 HUGHES ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921156515",
            "telephone_number": "619-750-8393",
            "fax_number": "619-286-3478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARRUJO",
        "first_name": "ROBERT",
        "middle_name": "(NONE)",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-09",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT13093",
            "primary": true
        }
    ],
    "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 Jul 9, 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.

Verify at the official NPI Registry.