Active NPI
Michael Sanden, DPT
- Physical Therapist
- Los Osos, CA
National Provider Identifier
1912142944
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT35017
- Practice address
- 2115 10TH St
Los Osos, CA 93402-3244 - Phone
- (805) 528-3002
- Fax
- (805) 528-5341
- NPI assigned
- Dec 4, 2008
- Last updated
- Sep 23, 2011
- 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 | PT35017 | CA | Primary |
Addresses
Primary practice location
2115 10TH St
Los Osos, CA 93402-3244
Mailing address
2115 10TH St
Suite B
Los Osos, CA 93402-3244
Phone (805) 528-3002
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PT35017 | Other | CA | STATE LICENSE |
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 |
|---|---|---|---|
| 35017 | CA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Joseph Boehm, P.T. | Physical Therapist | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1228348800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1316736000000",
"number": "1912142944",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2115 10TH ST",
"address_2": "SUITE B",
"city": "LOS OSOS",
"state": "CA",
"postal_code": "934023244",
"telephone_number": "805-528-3002",
"fax_number": "805-528-5341"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2115 10TH ST",
"city": "LOS OSOS",
"state": "CA",
"postal_code": "934023244",
"telephone_number": "805-528-3002",
"fax_number": "805-528-5341"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANDEN",
"first_name": "MICHAEL",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-12-04",
"last_updated": "2011-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "PT35017",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "PT35017",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Los Osos, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.