Provider Demographics
NPI:1578772463
Name:ANG, JONATHAN YEE (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:MR
First Name:JONATHAN
Middle Name:YEE
Last Name:ANG
Suffix:
Gender:M
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1517 W CARSON ST
Mailing Address - Street 2:#19
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90501-3942
Mailing Address - Country:US
Mailing Address - Phone:310-618-4298
Mailing Address - Fax:
Practice Address - Street 1:1517 W CARSON ST.,
Practice Address - Street 2:#19
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90501
Practice Address - Country:US
Practice Address - Phone:310-618-4298
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT30369225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist