Individual provider Active NPI

Therdphong Ninklung

  • Massage Therapist
  • San Diego, CA
National Provider Identifier
1629919733
Registry record updated Apr 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
88269 Issued in CA
Practice address
11300 Sorrento Valley Rd
San Diego, CA 92121-1328
Phone
(858) 519-7867
NPI assigned
Apr 2, 2026
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 2, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 88269 CA Primary

Addresses

Primary practice location

11300 Sorrento Valley Rd
San Diego, CA 92121-1328

Mailing address

11300 Sorrento Valley Rd
San Diego, CA 92121-1328
Phone (858) 519-7867

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

NPI Registry JSON

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

{
    "created_epoch": "1775088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775088000000",
    "number": "1629919733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11300 SORRENTO VALLEY RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921211328",
            "telephone_number": "858-519-7867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11300 SORRENTO VALLEY RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921211328",
            "telephone_number": "858-519-7867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NINKLUNG",
        "first_name": "THERDPHONG",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-04-02",
        "last_updated": "2026-04-02",
        "certification_date": "2026-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "CA",
            "license": "88269",
            "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 Apr 2, 2026; 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.