Individual provider Active NPI

Yousef Issa Ghandour, PT

  • Physical Therapist
  • San Diego, CA
National Provider Identifier
1932213188
Registry record updated Dec 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT13475 Issued in CA
Practice address
4435 Eastgate Mall Ste 120
San Diego, CA 92121-1980
Phone
(858) 587-8669
NPI assigned
Aug 17, 2006
Last updated
Dec 13, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2018

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 PT13475 CA Primary

Addresses

Primary practice location

4435 Eastgate Mall Ste 120
San Diego, CA 92121-1980

Mailing address

317 N El Camino Real
Ste 210
Encinitas, CA 92024-2813
Phone (760) 634-0248

Other practice location 1

9333 Genesee Ave
Suite 150
San Diego, CA 92121-2111
Phone (858) 453-3000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090622000586 CA Practitioner - Physical Therapist in Private Practice 7214900091 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2245 Camino Vida Roble
Suite 103
Carlsbad, CA 92011-1557
Phone (760) 683-8959

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT13475CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Eggleton & Langton Physical Therapy Management Services Physical Therapist CurrentSince Jul 10, 2017 Accepting new patients
Eggleton & Langton Physical Therapy Management Services Physical Therapist Past Accepting new patients
Eggleton Langton Physical Therapy Management Services Physical Therapist Past Accepting new patients
Eggleton & Langton Physical Therapy Management Services Physical Therapist Past Accepting new patients
Eggleton & Langton Physical Therapy Management Services Physical Therapist Past Accepting new patients
Eggleton & Langton Physical Therapy Management Services Physical Therapist Past Accepting new patients

Locations

2245 Camino Vida Roble
Ste 103
Carlsbad, CA 92011
Phone (760) 683-8959

317 N El Camino Real
Ste 210
Encinitas, CA 92024
Phone (760) 337-1144

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 7

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": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544659200000",
    "number": "1932213188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "317 N EL CAMINO REAL",
            "address_2": "STE 210",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920242813",
            "telephone_number": "760-634-0248",
            "fax_number": "760-634-1782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4435 EASTGATE MALL STE 120",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921211980",
            "telephone_number": "858-587-8669"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9333 Genesee Ave",
            "address_2": "Suite 150",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921212111",
            "country_code": "US",
            "telephone_number": "858-453-3000",
            "fax_number": "858-453-3066",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GHANDOUR",
        "first_name": "YOUSEF",
        "middle_name": "ISSA",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-17",
        "last_updated": "2018-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT13475",
            "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 Dec 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.