Active NPI
Abdon C Angeles, RPT
- Physical Therapist
- Los Angeles, CA
National Provider Identifier
1992944532
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 28280
- Practice address
- 2010 Wilshire Blvd
1007
Los Angeles, CA 90057-3507 - Phone
- (213) 989-0422
- NPI assigned
- Feb 4, 2009
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 28280 | CA | Primary |
Addresses
Primary practice location
2010 Wilshire Blvd
1007
Los Angeles, CA 90057-3507
Mailing address
2010 Wilshire Blvd
1007
Los Angeles, CA 90057-3507
Phone (213) 989-0422
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq | Health Information Exchange (HIE) | Southern California Permanente Medical Group |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28280 | CA | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Southern California Permanente Medical Group | Current | Accepting new patients |
Locations
6041 Cadillac Ave
Los Angeles, CA 90034
Phone (323) 857-2000
Organizations & group practices 2
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.
-
- Health Maintenance Organization
- Baldwin Park, CA
- NPI 1770515280
-
- Health Maintenance Organization
- Inglewood, CA
- NPI 1821635079
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1233705600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1638835200000",
"number": "1992944532",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2010 WILSHIRE BLVD",
"address_2": "1007",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900573507",
"telephone_number": "213-989-0422"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2010 WILSHIRE BLVD",
"address_2": "1007",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900573507",
"telephone_number": "213-989-0422"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANGELES",
"first_name": "ABDON",
"middle_name": "C",
"credential": "RPT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-02-04",
"last_updated": "2021-12-07",
"certification_date": "2021-12-07",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "28280",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
"affiliation": "Y",
"endpointDescription": "Carequality",
"affiliationName": "Southern California Permanente Medical Group",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "10800 Magnolia Ave",
"city": "Riverside",
"state": "CA",
"country_code": "US",
"postal_code": "925053043",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Los Angeles, CA
- Angeles Home Health Care, Inc.
- Angeles Medical Clinic, Inc.
- Angeles Psychology Group
- Angeles Psychology Group, a Professional Psychology Corporation
- Nancy Jazmin Angeles-Lopez
- Adrianne Angeles, LCSW
- Angelito Pascual Angeles
- Constance Angeles
- Constancia Angeles, D.M.D.
- Kristen Colleen Angelica, M.A., CCC-SLP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2021; 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.