Provider Demographics
NPI:1437290780
Name:CHINATOWN PHYSICAL THERAPY & REHABILITATION
Entity Type:Organization
Organization Name:CHINATOWN PHYSICAL THERAPY & REHABILITATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DOROTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:CHUNG YEUNG
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:415-433-3318
Mailing Address - Street 1:728 PACIFIC AVE
Mailing Address - Street 2:STE 301
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94133-4457
Mailing Address - Country:US
Mailing Address - Phone:415-433-3318
Mailing Address - Fax:
Practice Address - Street 1:728 PACIFIC AVE
Practice Address - Street 2:STE 301
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94133-4457
Practice Address - Country:US
Practice Address - Phone:415-433-3318
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-09
Last Update Date:2008-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14973225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPT0149730OtherMEDI-CAL PROVIDER NUMBER
CA14973OtherPT BOARD OF CA LICENSE
CAR26616Medicare UPIN
CA00PT59901Medicare ID - Type Unspecified