Individual provider Active NPI

Danh Ngo, PT, DPT, OCS, SCS

  • Orthopedic Physical Therapist
  • Long Beach, CA
National Provider Identifier
1053628735
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
30350 Issued in CA
Practice address
3646 Long Beach Blvd Ste 106
Long Beach, CA 90807-6025
Phone
(562) 548-0876
Fax
(888) 510-3678
NPI assigned
Sep 2, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 30350 CA Primary
Sports Medicine (Physical Medicine & Rehabilitation) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2081S0010X PT30340 CA

Addresses

Primary practice location

3646 Long Beach Blvd Ste 106
Long Beach, CA 90807-6025

Mailing address

3646 Long Beach Blvd Ste 106
Long Beach, CA 90807-6025
Phone (562) 548-0876

Other practice location 1

1428 E 59th St
Long Beach, CA 90805-4345
Phone (562) 308-8893

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
30350CAMDGeneral Practice Dentistry
PT30340CAMDSports Medicine (Physical Medicine & Rehabilitation) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Revitalize Rehab Club Multi-Specialty PastSince Jul 24, 2022 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1283385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1053628735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3646 LONG BEACH BLVD STE 106",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908076025",
            "telephone_number": "562-548-0876",
            "fax_number": "888-510-3678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3646 LONG BEACH BLVD STE 106",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908076025",
            "telephone_number": "562-548-0876",
            "fax_number": "888-510-3678"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1428 E 59th St",
            "address_purpose": "LOCATION",
            "city": "Long Beach",
            "state": "CA",
            "postal_code": "908054345",
            "country_code": "US",
            "telephone_number": "562-308-8893",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGO",
        "first_name": "DANH",
        "name_prefix": "Dr.",
        "credential": "PT, DPT, OCS, SCS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-09-02",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CA",
            "license": "30350",
            "primary": true
        },
        {
            "code": "2081S0010X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "CA",
            "license": "PT30340",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.