Individual provider Active NPI

Khoa Vo

  • Physical Therapist
  • San Diego, CA
National Provider Identifier
1538996186
Registry record updated Sep 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
306444 Issued in CA
Practice address
3704 Ruffin Rd
San Diego, CA 92123-1812
Phone
(619) 930-9750
NPI assigned
Sep 17, 2024
Last updated
Sep 17, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2024

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 306444 CA Primary

Addresses

Primary practice location

3704 Ruffin Rd
San Diego, CA 92123-1812

Mailing address

3740 52ND St Apt 2
San Diego, CA 92105-3164
Phone (619) 315-8158

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241213003548 CA Practitioner - Physical Therapist in Private Practice 7719413616 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
May accept Medicare assignment
Group practices
Proactive Physical Therapy and Sports Medicine IncGroup PAC ID 1557369436, 51 clinicians

Practice addresses (Care Compare)

12264 El Camino Real
Suite 102
San Diego, CA 92130-3060
Phone (858) 509-9600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Proactive Physical Therapy & Sports Medicine Inc Physical Therapist CurrentSince Nov 10, 2024 Accepting new patients
DPT Holdings, LLC Physical Therapist PastSince Sep 1, 2025 Accepting new patients

Locations

6070 Avenida Encinas
Ste 100
Carlsbad, CA 92011
Phone (760) 444-0102

19582 Beach Blvd
Ste 130
Huntington Beach, CA 92648
Phone (714) 841-6162

12264 El Camino Real
Ste 102
San Diego, CA 92130
Phone (858) 509-9600

3704 Ruffin Rd
San Diego, CA 92123
Phone (619) 930-9750

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1726531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726531200000",
    "number": "1538996186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3740 52ND ST APT 2",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921053164",
            "telephone_number": "619-315-8158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3704 RUFFIN RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231812",
            "telephone_number": "619-930-9750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VO",
        "first_name": "KHOA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-09-17",
        "last_updated": "2024-09-17",
        "certification_date": "2024-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "306444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2024; 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.