ORIGIN PHYSICAL THERAPY CA INC
Complete NPI Record 1982169595
Physical Therapist in Los Angeles, CA

Active since February 07, 2019
11980 SAN VICENTE BLVD STE 100, LOS ANGELES, CA 90049(310) 241-4885(310) 479-2329 Get Directions

NPPES record last updated: May 27, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 27, 2026, Apr 1, 2026, Mar 23, 2026 and 10 more (13 updates tracked since 2019).

Complete NPI Dataset

This page contains the complete raw NPPES record for Origin Physical Therapy Ca Inc (NPI 1982169595), a physical therapist organization in Los Angeles, CA. All 29 fields on file are listed with their current values and official NPPES definitions, exactly as recorded in the National Plan and Provider Enumeration System. Only fields that contain data are included, so the number of fields shown varies from one NPI record to another.

Use the tools below to filter fields by category, search within the record, or jump straight to a specific field. You can download the full record as a CSV, JSON, Markdown or text file, or filter first and export only the fields you need. The Print Clean Summary button produces a printer-friendly copy of the record.

Registry File Document Utilities
NPI: 1982169595
Field 1/29
The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Entity Type Code: 2
Field 2/29
Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Employer Identification Number EIN: Not available
Field 3/29
The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
Provider Organization Name Legal Business Name: ORIGIN PHYSICAL THERAPY CA INC
Field 4/29
The name of the organization provider. If the provider is an organization, this is the legal business name.
Provider First Line Business Mailing Address: PO BOX 103230
Field 5/29
The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
Provider Business Mailing Address City Name: PASADENA
Field 6/29
The city name in the mailing address of the provider being identified.
Provider Business Mailing Address State Name: CA
Field 7/29
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
Provider Business Mailing Address Postal Code: 911893230
Field 8/29
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
Provider Business Mailing Address Country Code If outside U S : US
Field 9/29
The country code in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address country code".
Provider Business Mailing Address Telephone Number: 3104792323
Field 10/29
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
Provider Business Mailing Address Fax Number: 3104792329
Field 11/29
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as "Provider location address fax number".
Provider First Line Business Practice Location Address: 11980 SAN VICENTE BLVD STE 100
Field 12/29
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City Name: LOS ANGELES
Field 13/29
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State Name: CA
Field 14/29
The State code in the location of the provider being identified.
Provider Business Practice Location Address Postal Code: 900495012
Field 15/29
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code If outside U S : US
Field 16/29
The country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number: 3102414885
Field 17/29
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number: 3104792329
Field 18/29
The fax number associated with the location address of the provider being identified.
Authorized Official Last Name: CLAMPETT
Field 21/29
The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Authorized Official First Name: SARAH
Field 22/29
The first name of the authorized official.
Authorized Official Title or Position: MANAGER
Field 23/29
The title or position of the authorized official.
Authorized Official Telephone Number: 2138982673
Field 24/29
The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code 1: 225100000X
Field 25/29
This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
Healthcare Provider Primary Taxonomy Switch 1: Y
Field 26/29
This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
Is Organization Subpart: N
Field 27/29
Indicates whether the provider is a subpart of a larger organization. This is a single-character code: "Y" means the entity is an organizational subpart, while "N" means it is not. Subparts typically include hospital departments, clinics, or other distinct units that fall under a parent organization.
Healthcare Provider Taxonomy Group 1: 193400000X SINGLE SPECIALTY GROUP
Field 28/29
Specifies whether the provider is part of a single-specialty or multi-specialty business group. The possible values are: 193200000X – Multi-Specialty Group or 193400000X – Single Specialty Group. This field helps distinguish the organizational structure of a provider group.

Secondary Practice Locations 8

The first line of the secondary practice location address of the provider being identified. For providers with more than one physical location, this is a secondary practice location address. This address cannot include a Post Office box.

8160 Mira Mesa Blvd
Location 1/8
San Diego, CA 92126-2602 · Phone (213) 898-2673
7188 Avenida Encinas
Location 2/8
Carlsbad, CA 92011-4602 · Phone (213) 898-2673
1800 Filbert St
Location 3/8
San Francisco, CA 94123-3608 · Phone (213) 898-2673
2011 Palomar Airport Rd Ste 300
Location 4/8
Carlsbad, CA 92011-1432 · Phone (213) 893-4268
225 W Broadway Ste 120
Location 5/8
Glendale, CA 91204-1312 · Phone (213) 893-4268
8376 Beverly Blvd
Location 6/8
Los Angeles, CA 90048-2631 · Phone (213) 898-2673
2915 Telegraph Ave Ste 302
Location 7/8
Berkeley, CA 94705-2030 · Phone (213) 898-2673
330 N Brand Blvd Ste 235
Location 8/8
Glendale, CA 91203-2363 · Phone (213) 898-2673
No registry entries match your active lookup criteria.