Spot Physical Therapy Inc

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

SPOT PHYSICAL THERAPY INC

Practice address

411 S Central Ave.
Glendale, CA 91204-1601

Phone

(818) 940-6015

Fax

(818) 272-8632

NPI assigned

Apr 30, 2021

Organization subpart

No

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

Authorized official

Name

Mr. David Dallakian

Title

Owner

Phone

(818) 452-2722

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ryan Dwight Breneman

  • Physical Therapist
  • Glendale, CA
  • NPI 1073392437
  NPD

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

{
    "created_epoch": "1619740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619740800000",
    "number": "1972186633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 S CENTRAL AVE.",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912041601",
            "telephone_number": "818-452-2722",
            "fax_number": "818-272-8632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 S CENTRAL AVE.",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912041601",
            "telephone_number": "818-940-6015",
            "fax_number": "818-272-8632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPOT PHYSICAL THERAPY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-30",
        "last_updated": "2021-04-30",
        "certification_date": "2021-04-05",
        "status": "A",
        "authorized_official_last_name": "DALLAKIAN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "818-452-2722",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapy Clinic/Center in Glendale, CA
• Providers in Glendale, CA by specialty
• Physical Therapy Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2021; 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.