Lianne K Koo, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT38056 Issued in CA

Practice address

325 Main St
El Segundo, CA 90245

Phone

(310) 648-3167

Fax

(310) 648-3175

NPI assigned

Nov 8, 2011

Last updated

Aug 9, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Lianne K Nakazaki Former name

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Davis and Derosa Physical Therapy IncGroup PAC ID 7113954264, 21 clinicians

Manhattan Beach Pacific Physical Therapy IncGroup PAC ID 4587619457, 11 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Davis and Derosa Physical Therapy, Inc

  • Physical Therapist
  • El Segundo, CA
  • NPI 1558414102
  Medicare reassignment Care Compare group NPD
• Manhattan Beach Pacific Physical Therapy Inc

  dba Pacific Physical Therapy

  • Physical Therapist
  • El Segundo, CA
  • NPI 1396799458
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1320710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533772800000",
    "number": "1063799898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 MAIN ST",
            "city": "EL SEGUNDO",
            "state": "CA",
            "postal_code": "902453814",
            "telephone_number": "310-648-3167",
            "fax_number": "310-648-3175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 MAIN ST",
            "city": "EL SEGUNDO",
            "state": "CA",
            "postal_code": "90245",
            "telephone_number": "310-648-3167",
            "fax_number": "310-648-3175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOO",
        "first_name": "LIANNE",
        "middle_name": "K",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-08",
        "last_updated": "2018-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT38056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LIANNE",
            "last_name": "NAKAZAKI",
            "middle_name": "K",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Dakota Kolacek
• Omolara Kolawle
• Veda Komati
• Fernando Kong
• Kevin Kong
• Ayub Korane
• Olivia Korch
• Karan Ann Kortlander, N.P.
• Ria Kotak
• Yvette Leila Kraiss, M.A., LMFT

• Physical Therapist in El Segundo, CA
• Providers in El Segundo, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2018; 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.