Active NPI
Yousef Issa Ghandour, PT
- Physical Therapist
- San Diego, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT13475
- 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, 2018
- 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 | 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
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
| License | State | Type | Specialty |
|---|---|---|---|
| PT13475 | CA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eggleton & Langton Physical Therapy Management Services | Physical Therapist | Current | 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.
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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.