Active NPI
Hasmin Ilagan Panem, OTR/L
- Occupational Therapist
- San Dimas, CA
National Provider Identifier
1972872091
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT7862
- Practice address
- 1740 S San Dimas Ave
San Dimas, CA 91773-5108 - Phone
- (909) 394-0304
- Fax
- (909) 305-4647
- NPI assigned
- Dec 19, 2011
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OT7862 | CA | Primary |
Addresses
Primary practice location
1740 S San Dimas Ave
San Dimas, CA 91773-5108
Mailing address
2222 Sullivan TRL
Easton, PA 18040-7958
Phone (800) 944-9782
Other names 1
- Hasmin Cabillan Ilagan
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120202000920 | CA | Practitioner - Occupational Therapist in Private Practice | 8224295266 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OT7862 | CA | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rehabcare Unlimited Corporation | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Physical Therapist
- Panorama City, CA
- NPI 1790151447
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1324252800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1324252800000",
"number": "1972872091",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2222 SULLIVAN TRL",
"city": "EASTON",
"state": "PA",
"postal_code": "180407958",
"telephone_number": "800-944-9782",
"fax_number": "610-438-2046"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1740 S SAN DIMAS AVE",
"city": "SAN DIMAS",
"state": "CA",
"postal_code": "917735108",
"telephone_number": "909-394-0304",
"fax_number": "909-305-4647"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PANEM",
"first_name": "HASMIN",
"middle_name": "ILAGAN",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-12-19",
"last_updated": "2011-12-19",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CA",
"license": "OT7862",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "HASMIN",
"last_name": "ILAGAN",
"middle_name": "CABILLAN",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in San Dimas, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.