Healthcare Provider Details

I. General information

NPI: 1952357618
Provider Name (Legal Business Name): GODFREY CHAN SAY PT, MPT, PMA-CPT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/25/2006
Last Update Date: 09/18/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 CORPORATE DRIVE UNIT #919
LADERA RANCH CA
92694-1118
US

IV. Provider business mailing address

2000 CORPORATE DRIVE UNIT #919
LADERA RANCH CA
92694-1118
US

V. Phone/Fax

Practice location:
  • Phone: 949-973-2637
  • Fax:
Mailing address:
  • Phone: 949-973-2637
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT29283
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License NumberPT29283
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: