Individual provider Active NPI

Kevin Leung, PT, DPT

  • Physical Therapist
  • San Diego, CA
National Provider Identifier
1588311898
Registry record updated Mar 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
301823 Issued in CA
Practice address
10806 Willow CT Ste 2
San Diego, CA 92127-2428
Phone
(619) 695-0688
NPI assigned
Mar 7, 2022
Last updated
Mar 7, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2022

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 301823 CA Primary

Addresses

Primary practice location

10806 Willow CT Ste 2
San Diego, CA 92127-2428

Mailing address

10806 Willow CT Ste 2
San Diego, CA 92127-2428
Phone (619) 695-0688

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
301823CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Deluca Mull Chiropractic Kinetic Impact Rehab and Performance Inc CurrentSince Jul 3, 2022 Accepting new patients

Locations

10806 Willow Ct
Ste 2
San Diego, CA 92127
Phone (619) 695-0688

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.

NPI Registry JSON

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

{
    "created_epoch": "1646611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646611200000",
    "number": "1588311898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10806 WILLOW CT STE 2",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921272428",
            "telephone_number": "619-695-0688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10806 WILLOW CT STE 2",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921272428",
            "telephone_number": "619-695-0688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEUNG",
        "first_name": "KEVIN",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-03-07",
        "last_updated": "2022-03-07",
        "certification_date": "2022-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "301823",
            "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 Mar 7, 2022; 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.