Individual provider Active NPI

Qin Yao, PT

  • Physical Therapist
  • San Gabriel, CA
National Provider Identifier
1730877887
Registry record updated Apr 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
26209 Issued in CA
Practice address
1788 S San Gabriel Blvd
San Gabriel, CA 91776-3978
Phone
(626) 656-6253
Fax
(626) 573-8643
NPI assigned
Apr 26, 2023
Last updated
Apr 26, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2023

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 26209 CA Primary

Addresses

Primary practice location

1788 S San Gabriel Blvd
San Gabriel, CA 91776-3978

Mailing address

5616 Noel Dr
Temple City, CA 91780-2319

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230606002113 CA Practitioner - Physical Therapist in Private Practice 5395102339 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Wynk's Clinic CurrentSince Apr 1, 2023 Accepting new patients
Wynk's Corporation CurrentSince Apr 1, 2023 Accepting new patients

Locations

1788 S San Gabriel Blvd
Ste 101
San Gabriel, CA 91776
Phone (626) 656-6253

1806 S San Gabriel Blvd
San Gabriel, CA 91776
Phone (626) 377-0515

Organizations & group practices 2

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": "1682467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682467200000",
    "number": "1730877887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5616 NOEL DR",
            "city": "TEMPLE CITY",
            "state": "CA",
            "postal_code": "917802319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1788 S SAN GABRIEL BLVD",
            "city": "SAN GABRIEL",
            "state": "CA",
            "postal_code": "917763978",
            "telephone_number": "626-656-6253",
            "fax_number": "626-573-8643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAO",
        "first_name": "QIN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-26",
        "last_updated": "2023-04-26",
        "certification_date": "2023-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "26209",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Gabriel, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2023; 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.