Active NPI
Casey Chung
- Kinesiotherapist
- Redlands, CA
National Provider Identifier
1174263354
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Kinesiotherapist
- License
- 1901
- Practice address
- 26001 Redlands Blvd
Redlands, CA 92373-7762 - Phone
- (909) 825-7084
- NPI assigned
- Mar 29, 2022
- 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 |
|---|---|---|---|---|
| Kinesiotherapist | 226300000X | 1901 | CA | Primary |
Addresses
Primary practice location
26001 Redlands Blvd
Redlands, CA 92373-7762
Mailing address
11273 Terra Vista Pkwy Apt D
Rancho Cucamonga, CA 91730-7417
Other practice location 1
11201 Benton St
Loma Linda, CA 92357-1000
Phone (909) 825-7084 ext. 7012
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 |
|---|---|---|---|
| 1901 | CA | MD | Kinesiotherapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1648512000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1648512000000",
"number": "1174263354",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11273 TERRA VISTA PKWY APT D",
"city": "RANCHO CUCAMONGA",
"state": "CA",
"postal_code": "917307417"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "26001 REDLANDS BLVD",
"city": "REDLANDS",
"state": "CA",
"postal_code": "923737762",
"telephone_number": "909-825-7084"
}
],
"practiceLocations": [
{
"address_1": "11201 Benton St",
"address_purpose": "LOCATION",
"city": "Loma Linda",
"state": "CA",
"postal_code": "923571000",
"country_code": "US",
"telephone_number": "909-825-7084 x7012",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CHUNG",
"first_name": "CASEY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-03-29",
"last_updated": "2022-03-29",
"certification_date": "2022-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "226300000X",
"taxonomy_group": "",
"desc": "Kinesiotherapist",
"state": "CA",
"license": "1901",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Redlands, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 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.