Randy Chan, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT43427 Issued in CA

Practice address

82013 Dr Carreon Blvd
Ste I
Indio, CA 92201-4832

Phone

(760) 347-6195

Fax

(760) 347-2849

NPI assigned

Apr 17, 2012

Last updated

Dec 17, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1334620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450310400000",
    "number": "1811254741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1106 WALNUT ST",
            "address_2": "SUITE 110",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934012416",
            "telephone_number": "805-540-4359",
            "fax_number": "805-200-3769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "82013 DR CARREON BLVD",
            "address_2": "STE I",
            "city": "INDIO",
            "state": "CA",
            "postal_code": "922014832",
            "telephone_number": "760-347-6195",
            "fax_number": "760-347-2849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "RANDY",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-17",
        "last_updated": "2015-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT43427",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lizette Cerna
• Kenneth Charles Chadwick Jr.
• Lency Annette Chaidez, LVN
• Sharon Gisell Chajon Gatica
• MC Michael Balsamo Chan, PMHNP-BC
• Chandrashekar Medical Corporation
• Jambur Eriah Chandrashekar, M.D.
• Narendra Shashibushan Chandrashekar, M.D.
• Charles Kim MD Inc
• Maria Guadalupe Chavez-Brown

• Physical Therapist in Indio, CA
• Providers in Indio, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.