Active NPI
Peter Quan
- Physical Therapist
- Azusa, CA
National Provider Identifier
1427096692
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT 30117
- Practice address
- 830 S. Citrus Ave. Suite 203
Azusa, CA 91702 - Phone
- (626) 963-0583
- Fax
- (626) 857-5515
- NPI assigned
- Jun 2, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT 30117 | CA | Primary |
Addresses
Primary practice location
830 S. Citrus Ave. Suite 203
Azusa, CA 91702
Mailing address
2298 Black Pine Rd
Chino Hills, CA 91709-4706
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT 30117 | CA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| South Pacific Rehabilitation Services, Inc | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Physical Therapist
- Lancaster, CA
- NPI 1447205828
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149206400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1427096692",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2298 BLACK PINE RD",
"city": "CHINO HILLS",
"state": "CA",
"postal_code": "917094706"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "830 S. CITRUS AVE. SUITE 203",
"city": "AZUSA",
"state": "CA",
"postal_code": "91702",
"telephone_number": "626-963-0583",
"fax_number": "626-857-5515"
}
],
"practiceLocations": [],
"basic": {
"last_name": "QUAN",
"first_name": "PETER",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "PT 30117",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Azusa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.