MEDICARE: TONY DANG DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	300929	CA

General Provider Information

NPI Number	:	1528727963
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TONY DANG DPT

Provider Business Mailing Address
First Line	:	1128 S ALMANSOR ST
Second Line	:
City	:	ALHAMBRA
State	:	CA
Zip	:	91801-4858
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3407 W 6TH ST STE 514
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90020-2552
Country	:	US
Telephone Number	:	213-915-0300
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/13/2021
Last Update Date	:	10/17/2023

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