MEDICARE: PRESTON CHUN-SUM CHAU PT, DPT

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	225100000X	Physical Therapist	308966	CA

General Provider Information

NPI Number	:	1871465864
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PRESTON CHUN-SUM CHAU PT, DPT

Provider Business Mailing Address
First Line	:	11478 WINDING RIDGE DR
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92131-2943
Country	:	US
Telephone Number	:	858-366-2663
Fax Number	:

Provider Business Practice Location Address
First Line	:	590 S FAIR OAKS AVE # 110
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91105-2614
Country	:	US
Telephone Number	:	818-369-7620
Fax Number	:

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

Provider Enumeration Date	:	09/19/2025
Last Update Date	:	09/19/2025

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