Healthcare Provider Details

I. General information

NPI: 1255472221
Provider Name (Legal Business Name): BVC THERAPY GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/10/2007
Last Update Date: 09/04/2022
Certification Date: 09/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6301 BEACH BLVD STE 109
BUENA PARK CA
90621-4030
US

IV. Provider business mailing address

16377 LAS CUMBRES DR
WHITTIER CA
90603-1139
US

V. Phone/Fax

Practice location:
  • Phone: 714-675-4817
  • Fax: 714-994-8090
Mailing address:
  • Phone: 562-943-9559
  • Fax: 562-943-7518

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC25672
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT1465
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT17004
License Number StateCA

VIII. Authorized Official

Name: HUBERT CHANG
Title or Position: MANAGING PARTNER
Credential: DC
Phone: 714-675-4817