Koh Physical Therapy, Inc.

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

KOH PHYSICAL THERAPY, INC.

Practice address

9080 Irvine Center Dr
Irvine, CA 92618-4658

Phone

(949) 540-5641

Fax

(949) 540-5642

NPI assigned

Dec 8, 2006

Organization subpart

No

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

Authorized official

Name

Davis Y. Koh, DPT, MBA, GCS, CSCSNPI 1003840562

Title

Physical Therapist

Phone

(949) 540-5641

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Davis Y Koh, DPT, MBA, GCS, CSCS

  • Physical Therapist
  • Irvine, CA
  • NPI 1003840562
  Medicare reassignment Care Compare group NPD Authorized official
• Ren Kuwaye-Tamanaha

  • Physical Therapist
  • Irvine, CA
  • NPI 1083450357
  Medicare reassignment Care Compare group NPD
• Lionel Reyes, PTA

  • Physical Therapy Assistant
  • Fountain Valley, CA
  • NPI 1538872205
  NPD (past)
• Ma Theresa Laxamana Yumul, AD

  • Physical Therapy Assistant
  • Irvine, CA
  • NPI 1174211056
  NPD (past)

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694390400000",
    "number": "1144389701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9080 IRVINE CENTER DR",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926184658",
            "telephone_number": "949-540-5641",
            "fax_number": "949-540-5642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9080 IRVINE CENTER DR",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926184658",
            "telephone_number": "949-540-5641",
            "fax_number": "949-540-5642"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1760 Termino Ave # G19",
            "address_purpose": "LOCATION",
            "city": "Long Beach",
            "state": "CA",
            "postal_code": "908042105",
            "country_code": "US",
            "telephone_number": "949-540-5641",
            "fax_number": "949-540-5642",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KOH PHYSICAL THERAPY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-08",
        "last_updated": "2023-09-11",
        "certification_date": "2023-09-11",
        "status": "A",
        "authorized_official_last_name": "KOH",
        "authorized_official_first_name": "DAVIS",
        "authorized_official_middle_name": "Y.",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "949-540-5641",
        "authorized_official_credential": "DPT, MBA, GCS, CSCS"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT21306",
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00197420",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PT0213060",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ69559Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David Koehler, BCBA
• Carylanne Koenig Rogers
• Leah Mingwei Koenig
• Mindy S Koenig, LISW
• Gina Kofman
• Davis Y Koh, DPT, MBA, GCS, CSCS
• Dongwuk Koh
• Maryam Kohanbani, RNFA,CNOR
• Diane Elizabeth Kohler, RDN
• Casey Kohn, LMFT

• Physical Therapy Clinic/Center in Irvine, CA
• Providers in Irvine, CA by specialty
• Physical Therapy Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.