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General NPI Number Information
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NPI Number | 1174297246
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Entity Type | Organization
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Legal Business Name | DANG PT
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Dates
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Enumeration Date | 08/03/2021
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Last Update Date | 08/03/2021
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Provider Practice Location Address
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Address Line | 1021 E WALNUT ST STE 100
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City | PASADENA
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State | CA
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Zip | 91106-1478
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Country | US
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Telephone | 626-215-8475
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Fax |
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Provider Business Mailing Address
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Address Line | 745 YALE ST APT 5
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City | LOS ANGELES
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State | CA
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Zip | 90012-2332
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Country | US
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Telephone | 626-215-8475
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPIST
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Name | TONY C DANG
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Credential | DPT
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Telephone | 626-215-8475
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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