Provider Demographics
NPI:1174297246
Name:DANG PT
Entity Type:Organization
Organization Name:DANG PT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:TONY
Authorized Official - Middle Name:C
Authorized Official - Last Name:DANG
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:626-215-8475
Mailing Address - Street 1:745 YALE ST APT 5
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90012-2332
Mailing Address - Country:US
Mailing Address - Phone:626-215-8475
Mailing Address - Fax:
Practice Address - Street 1:1021 E WALNUT ST STE 100
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91106-1478
Practice Address - Country:US
Practice Address - Phone:626-215-8475
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-03
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy