Amanda Chan, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT304770 Issued in CA

Practice address

11150 W Olympic Blvd Ste 1050 #562
Los Angeles, CA 90064-1850

Phone

(310) 774-4665

NPI assigned

Jan 22, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ilya Kaminsky DC a Professional CorporationGroup PAC ID 8325190168, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Ilya Kaminsky DC a Professional Corporation

  • Physical Therapist
  • Los Angeles, CA
  • NPI 1417128125
  Medicare reassignment Care Compare group NPD
• Wholenessrx Physical Therapy Corporation

  • Physical Therapist
  • Los Angeles, CA
  • NPI 1457154189
  NPD Authorized official

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

{
    "created_epoch": "1705881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706140800000",
    "number": "1730940339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11150 W OLYMPIC BLVD STE 1050 #562",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900641850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11150 W OLYMPIC BLVD STE 1050 #562",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900641850",
            "telephone_number": "310-774-4665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "AMANDA",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-01-22",
        "last_updated": "2024-01-25",
        "certification_date": "2024-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT304770",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julia S Chan-Lopez, FNP-C
• Albert Wai-Tuck Chan, MD
• Alexander Chan
• Alfie Roman D. Chan, P.T
• Alvin Chan
• Ana Bertha Chan, COMMUNITY WORKER
• Andrew Chan
• Andrew Steven Chan, MD
• Andy Chan, MD
• Anita Chan

• Physical Therapist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.