Active NPI
Michael Chan, DPT
- Physical Therapist
- Redondo Beach, CA
National Provider Identifier
1235775784
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 38391
- Practice address
- 2207 Rockefeller LN Apt a
Redondo Beach, CA 90278-4488 - Phone
- (808) 381-4811
- NPI assigned
- Nov 19, 2019
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 38391 | CA | Primary |
Addresses
Primary practice location
2207 Rockefeller LN Apt a
Redondo Beach, CA 90278-4488
Mailing address
2207 Rockefeller LN Apt a
Redondo Beach, CA 90278-4488
Phone (808) 381-4811
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 |
|---|---|---|---|
| 38391 | CA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1574121600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1662336000000",
"number": "1235775784",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2207 ROCKEFELLER LN APT A",
"city": "REDONDO BEACH",
"state": "CA",
"postal_code": "902784488",
"telephone_number": "808-381-4811"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2207 ROCKEFELLER LN APT A",
"city": "REDONDO BEACH",
"state": "CA",
"postal_code": "902784488",
"telephone_number": "808-381-4811"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAN",
"first_name": "MICHAEL",
"credential": "DPT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-11-19",
"last_updated": "2022-09-05",
"certification_date": "2022-09-05",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "38391",
"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 Sep 5, 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.