Omid Alex Kajbaf, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

40797 Issued in CA

Practice address

10604 Valley Spring LN
Toluca Lake, CA 91602-3277

Phone

(310) 614-8846

NPI assigned

Nov 29, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1448755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692144000000",
    "number": "1942674080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10604 VALLEY SPRING LN UNIT 106",
            "city": "TOLUCA LAKE",
            "state": "CA",
            "postal_code": "916023278",
            "telephone_number": "310-614-8846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10604 VALLEY SPRING LN",
            "city": "TOLUCA LAKE",
            "state": "CA",
            "postal_code": "916023277",
            "telephone_number": "310-614-8846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAJBAF",
        "first_name": "OMID",
        "middle_name": "ALEX",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-11-29",
        "last_updated": "2023-08-16",
        "certification_date": "2023-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "40797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Toluca Lake, CA
• Providers in Toluca Lake, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2023; 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.