Individual provider Active NPI

Devin Otagaki, DPT

  • Physical Therapist
  • Los Angeles, CA
National Provider Identifier
1962721621
Registry record updated May 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
34308 Issued in CA
Practice address
9201 W Sunset Blvd
Los Angeles, CA 90069-3701
Phone
(808) 292-1347
NPI assigned
May 20, 2010
Last updated
May 20, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 20, 2010

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 34308 CA Primary

Addresses

Primary practice location

9201 W Sunset Blvd
Los Angeles, CA 90069-3701

Mailing address

2126 Beachwood Ter
Los Angeles, CA 90068-3415

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

LicenseStateTypeSpecialty
34308CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Back2 Health Physical Therapy Inc Physical Therapist PastSince Dec 1, 2017 Accepting new patients
Walk & Roll Physical Therapy, LLC Physical Therapist Past Accepting new patients

Organizations & group practices 3

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": "1274313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274313600000",
    "number": "1962721621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2126 BEACHWOOD TER",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900683415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9201 W SUNSET BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900693701",
            "telephone_number": "808-292-1347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTAGAKI",
        "first_name": "DEVIN",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-05-20",
        "last_updated": "2010-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "34308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2010; 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.