Active NPI
Bobby Kou, OTD
- Occupational Therapist
- Redondo Beach, CA
National Provider Identifier
1194354233
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 6926
- Practice address
- 2012 Mathews Ave #B
Redondo Beach, CA 90278 - Phone
- (310) 350-8803
- NPI assigned
- Apr 1, 2020
- 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 | 6926 | CA | Primary |
Addresses
Primary practice location
2012 Mathews Ave #B
Redondo Beach, CA 90278
Mailing address
2012 Mathews Ave #B
Redondo Beach, CA 90278
Phone (310) 350-8803
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6926 | CA | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1585699200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1585699200000",
"number": "1194354233",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2012 MATHEWS AVE #B",
"city": "REDONDO BEACH",
"state": "CA",
"postal_code": "90278",
"telephone_number": "310-350-8803"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2012 MATHEWS AVE #B",
"city": "REDONDO BEACH",
"state": "CA",
"postal_code": "90278",
"telephone_number": "310-350-8803"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOU",
"first_name": "BOBBY",
"name_prefix": "Dr.",
"credential": "OTD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-04-01",
"last_updated": "2020-04-01",
"certification_date": "2020-04-01",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CA",
"license": "6926",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Redondo Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.