NPIMap

Organization Active NPI

Sparc Physical Therapy, Inc.

  • Physical Therapist
  • Torrance, CA
National Provider Identifier
1396205548
Registry record updated Jun 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
SPARC PHYSICAL THERAPY, INC.
Practice address
3878 W Carson St Ste 101
Torrance, CA 90503-6707
Phone
(310) 316-8878
Fax
(310) 316-8879
NPI assigned
Mar 23, 2019
Last updated
Jun 3, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2022

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

Authorized official

Name
Christopher Kwon, PT, DPTNPI 1790284446
Title
Ceo/President
Phone
(818) 792-0961

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU Primary
Physical Therapy Clinic/Center 261QP2000X NU

Addresses

Primary practice location

3878 W Carson St Ste 101
Torrance, CA 90503-6707

Mailing address

3878 W Carson St Ste 101
Torrance, CA 90503-6707
Phone (310) 316-8878

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200411000110 CA Part B Supplier - Clinic/Group Practice 1951730019 Receives reassigned benefits from 8 practitioners
Practice locations: Torrance, CA

National Provider Directory

National Provider Directory

Locations

3661 Torrance Blvd
Ste 202
Torrance, CA 90503
Phone (310) 316-8878

3878 W Carson St
Ste 101
Torrance, CA 90503
Phone (310) 316-8878

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1553299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654214400000",
    "number": "1396205548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3878 W CARSON ST STE 101",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905036707",
            "telephone_number": "310-316-8878",
            "fax_number": "310-316-8879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3878 W CARSON ST STE 101",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905036707",
            "telephone_number": "310-316-8878",
            "fax_number": "310-316-8879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPARC PHYSICAL THERAPY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-23",
        "last_updated": "2022-06-03",
        "certification_date": "2022-06-03",
        "status": "A",
        "authorized_official_last_name": "KWON",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "818-792-0961",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Torrance, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.