Individual provider Active NPI

Alexander Chan

  • Physical Therapist
  • Los Angeles, CA
National Provider Identifier
1265029375
Registry record updated Dec 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
299541 Issued in CA
Practice address
420 E 3Rd St # Ca
Los Angeles, CA 90013-1644
Phone
(213) 745-6106
NPI assigned
Dec 22, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 299541 CA Primary

Addresses

Primary practice location

420 E 3Rd St # Ca
Los Angeles, CA 90013-1644

Mailing address

401 N Marengo Ave
Alhambra, CA 91801-1954
Phone (626) 720-9376

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241230003375 CA Practitioner - Physical Therapist in Private Practice 2961939178 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Select CS Physical Therapy PCGroup PAC ID 1355742081, 177 clinicians

Practice addresses (Care Compare)

4640 Admiralty Way
Suite 420
Marina del Rey, CA 90292-6617
Phone (424) 526-5151

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Select CS Physical Therapy, P.C. CurrentSince Nov 20, 2024 Accepting new patients
Select CS Physical Therapy, P.C. CurrentSince Nov 20, 2024 Accepting new patients
Select CS Physical Therapy, P.C. Physical Therapist Current Accepting new patients

Locations

4640 Admiralty Way
Ste 420
Marina del Rey, CA 90292
Phone (424) 526-5151

2001 Wilshire Blvd
Ste 310
Santa Monica, CA 90403
Phone (310) 829-3320

Organizations & group practices 3

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": "1608595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608595200000",
    "number": "1265029375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 N MARENGO AVE",
            "city": "ALHAMBRA",
            "state": "CA",
            "postal_code": "918011954",
            "telephone_number": "626-720-9376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 E 3RD ST # CA",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900131644",
            "telephone_number": "213-745-6106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "ALEXANDER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-12-22",
        "last_updated": "2020-12-22",
        "certification_date": "2020-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "299541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2020; 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.