Kevin Phung

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

300400 Issued in CA

Practice address

12501 Seal Beach Blvd Ste 210
Seal Beach, CA 90740-2755

Phone

(562) 493-8800

Fax

(562) 493-2980

NPI assigned

Jun 30, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Rossmoor Rehabilitation IncGroup PAC ID 2769530153, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Rossmoor Rehabilitation Inc

  • Physical Therapist
  • Seal Beach, CA
  • NPI 1922251073
  Medicare reassignment Care Compare group NPD
• California Luna Care Physical Therapy PC

  • Physical Therapist
  • Los Gatos, CA
  • NPI 1689162166
  Medicare reassignment NPD

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

{
    "created_epoch": "1625011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625011200000",
    "number": "1306416458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11262 ELKWOOD ST",
            "city": "SUN VALLEY",
            "state": "CA",
            "postal_code": "913524437",
            "telephone_number": "818-471-3358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12501 SEAL BEACH BLVD STE 210",
            "city": "SEAL BEACH",
            "state": "CA",
            "postal_code": "907402755",
            "telephone_number": "562-493-8800",
            "fax_number": "562-493-2980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHUNG",
        "first_name": "KEVIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-30",
        "last_updated": "2021-06-30",
        "certification_date": "2021-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "300400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tao Sha Phalen, MASTER OF ACUPUNCTUR
• Lien Chau Thuy Phan
• Tony Phan, PT, DPT
• Vivian Thu-Van Phan, RPH
• Philip P. Nguyen, DDS Inc. (Seal Beach Dentistry)
• Trina Jane Physick, CMT
• Abelardo Pita, MD
• Douglas Jeffrey Poff, D.C.
• Prakash Narain, MD, Inc
• Joanne Marie Puleo, D.C.

• Physical Therapist in Seal Beach, CA
• Providers in Seal Beach, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2021; 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.