Provider Demographics
NPI:1104864701
Name:KANDA, LYNN TOSHIKO (PT, OCS)
Entity Type:Individual
Prefix:MS
First Name:LYNN
Middle Name:TOSHIKO
Last Name:KANDA
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Gender:F
Credentials:PT, OCS
Other - Prefix:
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Mailing Address - Street 1:10900 WARNER AVE
Mailing Address - Street 2:SUITE 111
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-3846
Mailing Address - Country:US
Mailing Address - Phone:714-964-3337
Mailing Address - Fax:714-964-8806
Practice Address - Street 1:10900 WARNER AVE
Practice Address - Street 2:SUITE 111
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-3846
Practice Address - Country:US
Practice Address - Phone:714-964-3337
Practice Address - Fax:714-964-8806
Is Sole Proprietor?:No
Enumeration Date:2006-06-04
Last Update Date:2013-04-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAPT11148225100000X, 2251H1200X, 2251P0200X, 2251S0007X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251H1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistHand
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
No2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPT11148OtherSTATE LICENSE
CAWPT11148AMedicare PIN