Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Novo F Bantolo, PT

Individual provider Physical Therapist · NPI 1255456752

Novo F Bantolo, PT is a Physical Therapist in Private Practice in Los Angeles, California. Qualified in 2013, 13 years ago. Practices with Southern California Permanente Medical Group, an 11,242-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
13
Licensed in
CA
In the registry since
2007
What do these letters mean?
PT — Physical Therapist
A licensed therapist who treats movement, pain and injury.

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Practice location Address checks out

6033 W Century Blvd Ste 200 & 201
Los Angeles, CA 90045-6410
Phone: (615) 778-4066
Fax: (615) 778-9114
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence PT 32795 (CA)

Record details

NPI number1255456752
Entity typeIndividual (Type 1)
GenderMale
Credentials PT
Sole proprietorNo
NPI enumeratedMarch 21, 2007
Last updated in NPPESNovember 29, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2013 (13 years in practice)
Group practice Southern California Permanente Medical Group — 11242 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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