Provider Demographics
NPI:1629623186
Name:KANG PHYSICAL THERAPY INC.
Entity Type:Organization
Organization Name:KANG PHYSICAL THERAPY INC.
Other - Org Name:SHINEBRIGHT PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:KWANGYO
Authorized Official - Middle Name:
Authorized Official - Last Name:KANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-691-9795
Mailing Address - Street 1:25301 CABOT RD STE 111
Mailing Address - Street 2:
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-5511
Mailing Address - Country:US
Mailing Address - Phone:949-691-9795
Mailing Address - Fax:949-763-3070
Practice Address - Street 1:25301 CABOT RD STE 111
Practice Address - Street 2:
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-5511
Practice Address - Country:US
Practice Address - Phone:949-691-9795
Practice Address - Fax:949-763-3070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-01
Last Update Date:2023-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy