NPIMap

Organization Active NPI

Base Training and Physical Therapy a California Corporation

  • Physical Therapist
  • Encino, CA
National Provider Identifier
1972916609
Registry record updated Aug 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
33851 Issued in CA
Legal business name
BASE TRAINING AND PHYSICAL THERAPY A CALIFORNIA CORPORATION
Practice address
17207 Ventura Blvd Ste 4
Encino, CA 91316-4035
Phone
(818) 386-8070
NPI assigned
Jun 10, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2024

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

Authorized official

Name
Sung KimNPI 1770761983
Title
Ceo, Owner
Phone
(818) 386-8070

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225100000X 33851 CA Primary

Addresses

Primary practice location

17207 Ventura Blvd Ste 4
Encino, CA 91316-4035

Mailing address

17207 Ventura Blvd Ste 4
Encino, CA 91316-4035
Phone (818) 386-8070

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140904001604 CA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 5890913859 Receives reassigned benefits from 6 practitioners
1 other NPI on this enrollment
Practice locations: Tarzana, CA

National Provider Directory

National Provider Directory

Locations

17207 Ventura Blvd
Ste 4
Encino, CA 91316
Phone (818) 386-8070

18801 Ventura Blvd
Ste 110
Tarzana, CA 91356
Phone (818) 386-8070

Practitioners & affiliated clinicians

Practitioners 8

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

NPI Registry JSON

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

{
    "created_epoch": "1402358400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722816000000",
    "number": "1972916609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17207 VENTURA BLVD STE 4",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913164035",
            "telephone_number": "818-386-8070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17207 VENTURA BLVD STE 4",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913164035",
            "telephone_number": "818-386-8070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BASE TRAINING AND PHYSICAL THERAPY A CALIFORNIA CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-10",
        "last_updated": "2024-08-05",
        "certification_date": "2024-08-05",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "SUNG",
        "authorized_official_title_or_position": "CEO, OWNER",
        "authorized_official_telephone_number": "818-386-8070"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "33851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Encino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2024; 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.