Active NPI
Ilene Kong, D.P.T.
- Physical Therapist
- Sherman Oaks, CA
National Provider Identifier
1265743587
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 33614
- Practice address
- 5230 Vesper Ave Apt 6
Sherman Oaks, CA 91411-4012 - Phone
- (909) 763-9330
- NPI assigned
- Jul 1, 2010
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 33614 | CA | Primary |
Addresses
Primary practice location
5230 Vesper Ave Apt 6
Sherman Oaks, CA 91411-4012
Mailing address
5230 Vesper Ave Apt 6
Sherman Oaks, CA 91411-4012
Phone (909) 763-9330
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 |
|---|---|---|---|
| 33614 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1277942400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1277942400000",
"number": "1265743587",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5230 VESPER AVE APT 6",
"city": "SHERMAN OAKS",
"state": "CA",
"postal_code": "914114012",
"telephone_number": "909-763-9330"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5230 VESPER AVE APT 6",
"city": "SHERMAN OAKS",
"state": "CA",
"postal_code": "914114012",
"telephone_number": "909-763-9330"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KONG",
"first_name": "ILENE",
"credential": "D.P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-07-01",
"last_updated": "2010-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "33614",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sherman Oaks, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.