Active NPI
Alfie Roman D. Chan, P.T
- Physical Therapist
- Los Angeles, CA
National Provider Identifier
1366802852
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Practice address
- 2105 Beverly Blvd
Suite 231
Los Angeles, CA 90057 - Phone
- (213) 483-1726
- Fax
- (213) 483-1733
- NPI assigned
- Feb 26, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | CA | Primary | |
| Orthopedic Physical Therapist | 2251X0800X |
Addresses
Primary practice location
2105 Beverly Blvd
Suite 231
Los Angeles, CA 90057
Mailing address
11024 Balboa Blvd
Suite 504
Granada Hills, CA 91344
Phone (818) 363-3000
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1456444800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1468972800000",
"number": "1366802852",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11024 BALBOA BLVD",
"address_2": "SUITE 504",
"city": "GRANADA HILLS",
"state": "CA",
"postal_code": "91344",
"telephone_number": "818-363-3000",
"fax_number": "888-833-2881"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2105 BEVERLY BLVD",
"address_2": "SUITE 231",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "90057",
"telephone_number": "213-483-1726",
"fax_number": "213-483-1733"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAN",
"first_name": "ALFIE ROMAN",
"middle_name": "D.",
"name_prefix": "Mr.",
"credential": "P.T",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-02-26",
"last_updated": "2016-07-20",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": null,
"primary": true
},
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"state": null,
"license": null,
"primary": false
}
],
"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 Jul 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.