Active NPI
Sonny Phan, MPT
- Physical Therapist
- San Jose, CA
National Provider Identifier
1841579950
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 22158
- Practice address
- 1976 Bernice Way
San Jose, CA 95124-2101 - Phone
- (408) 371-7752
- NPI assigned
- Aug 5, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 22158 | CA | Primary |
Addresses
Primary practice location
1976 Bernice Way
San Jose, CA 95124-2101
Mailing address
1976 Bernice Way
San Jose, CA 95124-2101
Phone (408) 371-7752
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1312502400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1312502400000",
"number": "1841579950",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1976 BERNICE WAY",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951242101",
"telephone_number": "408-371-7752"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1976 BERNICE WAY",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951242101",
"telephone_number": "408-371-7752"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHAN",
"first_name": "SONNY",
"credential": "MPT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-08-05",
"last_updated": "2011-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "22158",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Jose, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.