Individual provider Active NPI

Chiraporn Kunajak, RPT

  • Physical Therapist
  • Reseda, CA
National Provider Identifier
1790009348
Registry record updated Mar 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT7797 Issued in CA
Practice address
19231 Victory Blvd
200
Reseda, CA 91335-6308
Phone
(818) 776-0401
Fax
(818) 401-9390
NPI assigned
Mar 24, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2010

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 PT7797 CA Primary

Addresses

Primary practice location

19231 Victory Blvd
200
Reseda, CA 91335-6308

Mailing address

19231 Victory Blvd
200
Reseda, CA 91335-6308
Phone (818) 776-0401

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101111001016 CA Practitioner - Physical Therapist in Private Practice 1153516406 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1973
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dy Care Rehabilitation Therapy,IncGroup PAC ID 8123256500, 2 clinicians

Practice addresses (Care Compare)

3030 W Olympic Blvd
Suite 220
Los Angeles, CA 90006-6507
Phone (213) 739-6933

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT7797CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Dy Care Rehabilitation Therapy,Inc Physical Therapist CurrentSince Mar 16, 2018 Accepting new patients
Hope Physical Therapy Center, a Professional Corporation Physical Therapist CurrentSince Jul 12, 2017 Accepting new patients

Locations

2707 W Olympic Blvd
Ste 203
Los Angeles, CA 90006
Phone (213) 739-6933

3030 W Olympic Blvd
Ste 220
Los Angeles, CA 90006
Phone (213) 738-7788

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1269388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269388800000",
    "number": "1790009348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19231 VICTORY BLVD",
            "address_2": "200",
            "city": "RESEDA",
            "state": "CA",
            "postal_code": "913356308",
            "telephone_number": "818-776-0401",
            "fax_number": "818-401-9390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19231 VICTORY BLVD",
            "address_2": "200",
            "city": "RESEDA",
            "state": "CA",
            "postal_code": "913356308",
            "telephone_number": "818-776-0401",
            "fax_number": "818-401-9390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUNAJAK",
        "first_name": "CHIRAPORN",
        "credential": "RPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-24",
        "last_updated": "2010-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT7797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reseda, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2010; 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.