Active NPI
David Chung, OTR/L
- Occupational Therapist
- Willows, CA
National Provider Identifier
1700154705
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 12249
- Practice address
- 1133 W Sycamore St
Willows, CA 95988-2601 - Phone
- (530) 934-1800
- Fax
- (530) 934-1991
- NPI assigned
- Dec 5, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 12249 | CA | Primary |
Addresses
Primary practice location
1133 W Sycamore St
Willows, CA 95988-2601
Mailing address
1133 W Sycamore St
Willows, CA 95988-2601
Phone (530) 934-1800
Other practice location 1
27001 Agoura Rd Ste 210
Calabasas, CA 91301-5121
Phone (180) 537-1006
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12249 | CA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1323043200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1599523200000",
"number": "1700154705",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1133 W SYCAMORE ST",
"city": "WILLOWS",
"state": "CA",
"postal_code": "959882601",
"telephone_number": "530-934-1800",
"fax_number": "530-934-1991"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1133 W SYCAMORE ST",
"city": "WILLOWS",
"state": "CA",
"postal_code": "959882601",
"telephone_number": "530-934-1800",
"fax_number": "530-934-1991"
}
],
"practiceLocations": [
{
"address_1": "27001 Agoura Rd Ste 210",
"address_purpose": "LOCATION",
"city": "Calabasas",
"state": "CA",
"postal_code": "913015121",
"country_code": "US",
"telephone_number": "180-537-1006",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CHUNG",
"first_name": "DAVID",
"name_prefix": "Mr.",
"credential": "OTR/L",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-12-05",
"last_updated": "2020-09-08",
"certification_date": "2020-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CA",
"license": "12249",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Willows, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.