Dae-Eil Chong

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT-156 Issued in GU

Practice address

388 Ypao Rd
Tamuning, GU 96913-3701

Phone

(671) 646-8881

Fax

(671) 646-1292

NPI assigned

Oct 14, 2011

Last updated

Apr 25, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Sierra Physical Therapy Inc

  • Physical Therapist
  • Yuba City, CA
  • NPI 1811651714
  NPD

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

{
    "created_epoch": "1318550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682380800000",
    "number": "1831474410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20601 W PAOLI LANE",
            "city": "WEIMAR",
            "state": "CA",
            "postal_code": "95736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "388 YPAO RD",
            "city": "TAMUNING",
            "state": "GU",
            "postal_code": "969133701",
            "telephone_number": "671-646-8881",
            "fax_number": "671-646-1292"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1110 Civic Center Blvd Ste 502",
            "address_purpose": "LOCATION",
            "city": "Yuba City",
            "state": "CA",
            "postal_code": "959933015",
            "country_code": "US",
            "telephone_number": "530-671-7977",
            "fax_number": "530-671-6163",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHONG",
        "first_name": "DAE-EIL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-10-14",
        "last_updated": "2023-04-25",
        "certification_date": "2023-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "38707",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "033363",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GU",
            "license": "PT-156",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keith Ming Chan, PT
• Young Chang, MD
• Jim Nan Chen, M.D.
• Ramsey Neal Chichakli, M.D.
• Alison Chong, FNP
• James Grant Christian, O.D.
• Sarah Lee Clegg, D.D.S
• Phyllis Eileen Collins, C.N.P.
• Angela J.P. Cooey, PA-C
• Mariana L.G. Cook-Huynh, MD

• Physical Therapist in Tamuning, GU
• Providers in Tamuning, GU by specialty
• Physical Therapist in Guam

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2023; 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.