Healthcare Provider Details

I. General information

NPI: 1356714810
Provider Name (Legal Business Name): NEIL HAK TAING DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/05/2015
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16320 ROSCOE BLVD
VAN NUYS CA
91406-1250
US

IV. Provider business mailing address

11913 AVON WAY STE 4
LOS ANGELES CA
90066
US

V. Phone/Fax

Practice location:
  • Phone: 818-894-2273
  • Fax: 818-357-2505
Mailing address:
  • Phone: 270-320-4023
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number05012442A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number006756
License Number StateKY
# 3
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number295470
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: