Individual provider Active NPI

Willy Quach, DPT

  • Physical Therapist
  • Tarzana, CA
National Provider Identifier
1609349745
Registry record updated Aug 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
295978 Issued in CA
Practice address
18757 Burbank Blvd Ste 118
Tarzana, CA 91356-6345
Phone
(818) 813-5300
NPI assigned
Jan 10, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2019

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 295978 CA Primary

Addresses

Primary practice location

18757 Burbank Blvd Ste 118
Tarzana, CA 91356-6345

Mailing address

935 Hammond St
West Hollywood, CA 90069-4406

Other practice location 1

68 Willow Rd
Menlo Park, CA 94025-3653
Phone (866) 839-6979

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190523000813 CA Practitioner - Physical Therapist in Private Practice 7416290036 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Joel Z Scherr RPT Inc Physical Therapist CurrentSince Sep 30, 2020 Accepting new patients
California Luna Care Physical Therapy PC Physical Therapist CurrentSince Jun 17, 2019 Accepting new patients
Willpower Wellness and Physical Therapy Current Accepting new patients

Locations

415 N Crescent Dr
Ste 200
Beverly Hills, CA 90210
Phone (310) 657-8591

68 Willow Rd
Menlo Park, CA 94025
Phone (650) 691-8630

Organizations & group practices 3

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": "1547078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566950400000",
    "number": "1609349745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "935 HAMMOND ST",
            "city": "WEST HOLLYWOOD",
            "state": "CA",
            "postal_code": "900694406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18757 BURBANK BLVD STE 118",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913566345",
            "telephone_number": "818-813-5300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "68 Willow Rd",
            "address_purpose": "LOCATION",
            "city": "Menlo Park",
            "state": "CA",
            "postal_code": "940253653",
            "country_code": "US",
            "telephone_number": "866-839-6979",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "QUACH",
        "first_name": "WILLY",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-01-10",
        "last_updated": "2019-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "295978",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tarzana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2019; 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.