Healthcare Provider Details

I. General information

NPI: 1992318224
Provider Name (Legal Business Name): REBECCA CHENG-JU CHIN DPT, PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: REBECCA CHENG-JU YANG

II. Dates (important events)

Enumeration Date: 08/26/2020
Last Update Date: 08/26/2020
Certification Date: 08/26/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3230 E IMPERIAL HWY STE 100
BREA CA
92821-6735
US

IV. Provider business mailing address

3230 E IMPERIAL HWY STE 100
BREA CA
92821-6735
US

V. Phone/Fax

Practice location:
  • Phone: 714-988-8110
  • Fax: 714-988-8111
Mailing address:
  • Phone: 714-988-8110
  • Fax: 714-988-8111

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number298803
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: