Active NPI
Talita Cila Bolomey, D.P.T.
- Physical Therapist
- La Mesa, CA
National Provider Identifier
1932309200
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT33811
- Practice address
- 5565 Grossmont Center Drive
Suite 360
La Mesa, CA 91942 - Phone
- (619) 315-0035
- Fax
- (619) 315-0036
- NPI assigned
- Jul 24, 2007
- Last updated
- Feb 2, 2017
- Sex
- Female
- 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 | PT33811 | CA | Primary |
Addresses
Primary practice location
5565 Grossmont Center Drive
Suite 360
La Mesa, CA 91942
Mailing address
5565 Grossmont Center Drive
Suite 360
La Mesa, CA 91942
Phone (619) 315-0035
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 |
|---|---|---|---|
| 33811 | CA | MD | Chiropractor |
| PT33811 | CA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1185235200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1485993600000",
"number": "1932309200",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5565 GROSSMONT CENTER DRIVE",
"address_2": "SUITE 360",
"city": "LA MESA",
"state": "CA",
"postal_code": "91942",
"telephone_number": "619-315-0035",
"fax_number": "619-315-0036"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5565 GROSSMONT CENTER DRIVE",
"address_2": "SUITE 360",
"city": "LA MESA",
"state": "CA",
"postal_code": "91942",
"telephone_number": "619-315-0035",
"fax_number": "619-315-0036"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOLOMEY",
"first_name": "TALITA",
"middle_name": "CILA",
"credential": "D.P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-07-24",
"last_updated": "2017-02-02",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "PT33811",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in La Mesa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.