Individual provider Active NPI

Tini D DO, DPT

  • Physical Therapist
  • Garden Grove, CA
National Provider Identifier
1528089182
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT28250 Issued in CA
Practice address
10882 Westminster Ave
Garden Grove, CA 92843-4988
Phone
(714) 530-2364
NPI assigned
Jul 21, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT28250 CA Primary

Addresses

Primary practice location

10882 Westminster Ave
Garden Grove, CA 92843-4988

Mailing address

11804 Summerwood CT
Fountain Valley, CA 92708-2669
Phone (909) 262-2951

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

LicenseStateTypeSpecialty
PT28250CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
CHI Huu Phung, M.D., Inc CurrentSince Feb 29, 2020 Accepting new patients
Nuedge Physical Therapy Inc Physical Therapist Past Accepting new patients

Locations

13155 Brookhurst St
Garden Grove, CA 92843
Phone (714) 537-8487

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1528089182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11804 SUMMERWOOD CT",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927082669",
            "telephone_number": "909-262-2951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10882 WESTMINSTER AVE",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928434988",
            "telephone_number": "714-530-2364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DO",
        "first_name": "TINI",
        "middle_name": "D",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT28250",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden Grove, 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.

Verify at the official NPI Registry.