Provider Demographics
NPI:1285648816
Name:CHUANG, DEAN (MPT)
Entity Type:Individual
Prefix:
First Name:DEAN
Middle Name:
Last Name:CHUANG
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2700 E FOOTHILL BLVD
Mailing Address - Street 2:SUITE 121
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91107-7100
Mailing Address - Country:US
Mailing Address - Phone:626-449-4347
Mailing Address - Fax:626-449-4317
Practice Address - Street 1:2700 E FOOTHILL BLVD
Practice Address - Street 2:SUITE 121
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91107-7100
Practice Address - Country:US
Practice Address - Phone:626-449-4347
Practice Address - Fax:626-449-4317
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT28019225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ03532ZOtherBLUE SHIELD GROUP NUMBER
CAPT28019OtherBLUE CROSS CALIFORNIA
CAWPT28019AMedicare ID - Type UnspecifiedFOOTHILL LOCATION
CAWPT28019BMedicare ID - Type UnspecifiedWASHINGTON LOCATION