MEDICARE: GO BEYOND PEDIATRIC THERAPY INC.

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	225X00000X	Occupational Therapist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1467166256
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GO BEYOND PEDIATRIC THERAPY INC.

Provider Business Mailing Address
First Line	:	1143 TIMBERGATE LN
Second Line	:
City	:	BREA
State	:	CA
Zip	:	92821-6666
Country	:	US
Telephone Number	:	840-588-9908
Fax Number	:

Provider Business Practice Location Address
First Line	:	680 BREA CANYON RD STE 158
Second Line	:
City	:	WALNUT
State	:	CA
Zip	:	91789-3005
Country	:	US
Telephone Number	:	840-588-9908
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. CHIEN-YING YANG
Credential	:	PHD, OTR/L
Telephone Number	:	840-588-9908

Provider Enumeration Date	:	01/06/2023
Last Update Date	:	10/07/2024

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