Individual provider Active NPI

Vivian Hoi-Yan Chan, DPT, MS

  • Physical Medicine & Rehabilitation Physician
  • Santa Monica, CA
National Provider Identifier
1659003531
Registry record updated Jun 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
PT298575 Issued in CA
Practice address
2010 Wilshire Blvd
Santa Monica, CA 90403-5608
Phone
(310) 878-2540
NPI assigned
Jun 28, 2022
Last updated
Jun 28, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X PT298575 CA Primary

Addresses

Primary practice location

2010 Wilshire Blvd
Santa Monica, CA 90403-5608

Mailing address

1109 N Dalton Ave
Azusa, CA 91702-2127
Phone (626) 321-5063

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220725000457 CA Practitioner - Physical Therapist in Private Practice 2062893944 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Sportsfit Physical Therapy Corporation CurrentSince May 1, 2022 Accepting new patients

Locations

4702 Lincoln Blvd
Marina del Rey, CA 90292
Phone (310) 306-1478

2010 Wilshire Blvd
Santa Monica, CA 90403
Phone (310) 878-2540

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": "1656374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656374400000",
    "number": "1659003531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1109 N DALTON AVE",
            "city": "AZUSA",
            "state": "CA",
            "postal_code": "917022127",
            "telephone_number": "626-321-5063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2010 WILSHIRE BLVD",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904035608",
            "telephone_number": "310-878-2540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "VIVIAN",
        "middle_name": "HOI-YAN",
        "credential": "DPT, MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-28",
        "last_updated": "2022-06-28",
        "certification_date": "2022-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CA",
            "license": "PT298575",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2022; 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.