Active NPI
Kevin Cheng, PTA
- Physical Therapy Assistant
- Garden Grove, CA
National Provider Identifier
1174102693
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 50932
- Practice address
- 9764 Garden Grove Blvd
Garden Grove, CA 92844-1615 - Phone
- (714) 624-5941
- NPI assigned
- Apr 2, 2021
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 50932 | CA | Primary |
Addresses
Primary practice location
9764 Garden Grove Blvd
Garden Grove, CA 92844-1615
Mailing address
16433 Woodruff Ave Apt 35
Bellflower, CA 90706-4958
Phone (646) 864-9440
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
| License | State | Type | Specialty |
|---|---|---|---|
| 50932 | CA | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1617321600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1617321600000",
"number": "1174102693",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16433 WOODRUFF AVE APT 35",
"city": "BELLFLOWER",
"state": "CA",
"postal_code": "907064958",
"telephone_number": "646-864-9440"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9764 GARDEN GROVE BLVD",
"city": "GARDEN GROVE",
"state": "CA",
"postal_code": "928441615",
"telephone_number": "714-624-5941"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHENG",
"first_name": "KEVIN",
"name_prefix": "Mr.",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-04-02",
"last_updated": "2021-04-02",
"certification_date": "2021-04-02",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "CA",
"license": "50932",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Garden Grove, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.