Active NPI
Bryant Luong, MS, OTR/L
- Occupational Therapist
- Corte Madera, CA
National Provider Identifier
1154814754
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 18396
- Practice address
- 500 Tamal PLZ Ste 527
Corte Madera, CA 94925-1187 - Phone
- (949) 232-5834
- NPI assigned
- Jun 8, 2018
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 18396 | CA | Primary |
Addresses
Primary practice location
500 Tamal PLZ Ste 527
Corte Madera, CA 94925-1187
Mailing address
341 Riviera Dr
San Rafael, CA 94901-1528
Phone (949) 232-5834
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2597222 | Other | CA | MERCER/PROLIABILITY |
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
- Credentials
- Master of Science
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1528416000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1528416000000",
"number": "1154814754",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "341 RIVIERA DR",
"city": "SAN RAFAEL",
"state": "CA",
"postal_code": "949011528",
"telephone_number": "949-232-5834"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 TAMAL PLZ STE 527",
"city": "CORTE MADERA",
"state": "CA",
"postal_code": "949251187",
"telephone_number": "949-232-5834"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUONG",
"first_name": "BRYANT",
"credential": "MS, OTR/L",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-06-08",
"last_updated": "2018-06-08",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CA",
"license": "18396",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MERCER/PROLIABILITY",
"identifier": "2597222",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Corte Madera, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.