Individual provider Active NPI

Dongchang Yang, DPT

  • Physical Therapy Clinic/Center
  • San Gabriel, CA
National Provider Identifier
1174567093
Registry record updated May 26, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
PT28713 Issued in CA
Practice address
1228 S. San Gabriel Blvd
Ste. B
San Gabriel, CA 91776-3170
Phone
(626) 291-5025
Fax
(626) 291-5055
NPI assigned
Jun 15, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 26, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT28713 CA
Physical Therapy Clinic/Center 261QP2000X PT28713 CA Primary

Addresses

Primary practice location

1228 S. San Gabriel Blvd
Ste. B
San Gabriel, CA 91776-3170

Mailing address

1228 S. San Gabriel Blvd
Ste. B
San Gabriel, CA 91776-3170
Phone (626) 291-5025

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040210001232 CA Practitioner - Physical Therapist in Private Practice 2264326230 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4173 E Live Oak Ave
Arcadia, CA 91006-5828
Phone (626) 203-1922

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT28713CAMDPhysical Therapy Clinic/Center

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1243296000000",
    "number": "1174567093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1228 S. SAN GABRIEL BLVD",
            "address_2": "STE. B",
            "city": "SAN GABRIEL",
            "state": "CA",
            "postal_code": "917763170",
            "telephone_number": "626-291-5025",
            "fax_number": "626-291-5055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1228 S. SAN GABRIEL BLVD",
            "address_2": "STE. B",
            "city": "SAN GABRIEL",
            "state": "CA",
            "postal_code": "917763170",
            "telephone_number": "626-291-5025",
            "fax_number": "626-291-5055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YANG",
        "first_name": "DONGCHANG",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2009-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT28713",
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "CA",
            "license": "PT28713",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Gabriel, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2009; 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.