Individual provider Active NPI

Hasmin Ilagan Panem, OTR/L

  • Occupational Therapist
  • San Dimas, CA
National Provider Identifier
1972872091
Registry record updated Dec 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT7862 Issued in CA
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

Updated by the provider on Dec 19, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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 Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120202000920 CA Practitioner - Occupational Therapist in Private Practice 8224295266

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT7862CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew 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.

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.

Verify at the official NPI Registry.