Provider Demographics
NPI:1255472221
Name:BVC THERAPY GROUP
Entity Type:Organization
Organization Name:BVC THERAPY GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:HUBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:CHANG
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:714-675-4817
Mailing Address - Street 1:16377 LAS CUMBRES DR
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90603-1139
Mailing Address - Country:US
Mailing Address - Phone:562-943-9559
Mailing Address - Fax:562-943-7518
Practice Address - Street 1:6301 BEACH BLVD STE 109
Practice Address - Street 2:
Practice Address - City:BUENA PARK
Practice Address - State:CA
Practice Address - Zip Code:90621-4030
Practice Address - Country:US
Practice Address - Phone:714-675-4817
Practice Address - Fax:714-994-8090
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-10
Last Update Date:2022-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC25672111N00000X
CAPT17004225100000X
CAOT1465225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ66234ZOtherHC BLUE CROSS BLUE SHIELD
CAZZZ66235ZOtherFV BLUE CROSS BLUE SHIELD
CAZZZ66236ZOtherPB BLUE CROSS BLUE SHIELD
CAW19221Medicare PIN