MEDICARE: CHOEYING SANGMO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225200000X	Physical Therapy Assistant	52255	CA

General Provider Information

NPI Number	:	1134833361
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHOEYING SANGMO

Provider Business Mailing Address
First Line	:	29353 CANWOOD ST
Second Line	:
City	:	AGOURA HILLS
State	:	CA
Zip	:	91301-1594
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	29353 CANWOOD ST
Second Line	:
City	:	AGOURA HILLS
State	:	CA
Zip	:	91301-1594
Country	:	US
Telephone Number	:	747-225-8042
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/11/2023
Last Update Date	:	01/25/2023

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Directions to “ CHOEYING SANGMO ” Practice Location

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