Individual provider Active NPI

Jacob Atilano, PT

  • Specialist
  • Oakland, CA
National Provider Identifier
1982747960
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
PT 27010 Issued in CA
Practice address
350 30TH St, Suite 530
Oakland, CA 94609-3426
Phone
(510) 839-5564
Fax
(510) 839-1692
NPI assigned
Feb 15, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X PT 27010 CA Primary

Addresses

Primary practice location

350 30TH St, Suite 530
Oakland, CA 94609-3426

Mailing address

415 A St. #204
Daly City, CA 94014-3123
Phone (510) 839-5564

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PT 27010CAMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1982747960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 A ST. #204",
            "city": "DALY CITY",
            "state": "CA",
            "postal_code": "940143123",
            "telephone_number": "510-839-5564",
            "fax_number": "510-839-1692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 30TH ST, SUITE 530",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946093426",
            "telephone_number": "510-839-5564",
            "fax_number": "510-839-1692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATILANO",
        "first_name": "JACOB",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "PT 27010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.