Gavin Kam, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

305873 Issued in CA

Practice address

20280 SW Acacia St Ste 120
Newport Beach, CA 92660-0782

Phone

(949) 590-9350

Fax

(714) 361-2606

NPI assigned

Apr 4, 2024

Last updated

Apr 4, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2023

Medicare assignment

May accept Medicare assignment

Group practices

Rise Physical Therapy IncGroup PAC ID 2062636079, 55 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Rise Physical Therapy Inc

  dba SoCal Elite Physical Therapy

  • Physical Therapy Clinic/Center
  • Solana Beach, CA
  • NPI 1083038764

  Physical Therapist

  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1712188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712188800000",
    "number": "1033961784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20280 SW ACACIA ST STE 120",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926600782",
            "telephone_number": "949-590-9350",
            "fax_number": "714-361-2606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20280 SW ACACIA ST STE 120",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926600782",
            "telephone_number": "949-590-9350",
            "fax_number": "714-361-2606"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 Fashion Ln Ste 210",
            "address_purpose": "LOCATION",
            "city": "Tustin",
            "state": "CA",
            "postal_code": "927803306",
            "country_code": "US",
            "telephone_number": "949-590-9350 x2",
            "fax_number": "714-361-2604",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAM",
        "first_name": "GAVIN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-04-04",
        "last_updated": "2024-04-04",
        "certification_date": "2024-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "305873",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Juvive Inc
• K. Wensley. Michael MD, PC
• Douglas G Kahn, MD
• Ashton A. Kaidi, M.D.
• Charlotte Suzanne Kalb, AGNP-BC, PMHNP-BC
• Kamaldeep Singh Chiropractic Inc
• Steve Kamph, DC
• Jack Min Kan, M.D.
• Mark T Kan, M.D.
• Ellie Kang

• Physical Therapist in Newport Beach, CA
• Providers in Newport Beach, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.