Individual provider Active NPI

Supamas Tseng

  • Physical Therapist
  • Chula Vista, CA
National Provider Identifier
1891243945
Registry record updated Sep 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT291713 Issued in CA
Practice address
2437 Fenton St Ste a
Chula Vista, CA 91914-3517
Phone
(619) 934-3240
NPI assigned
Sep 19, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2016

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 PT291713 CA Primary

Addresses

Primary practice location

2437 Fenton St Ste a
Chula Vista, CA 91914-3517

Mailing address

1810 Avenida del Mundo
Unit 1207
Coronado, CA 92118-3003

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

State licenses

LicenseStateTypeSpecialty
PT291713CAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1474243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474243200000",
    "number": "1891243945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1810 AVENIDA DEL MUNDO",
            "address_2": "UNIT 1207",
            "city": "CORONADO",
            "state": "CA",
            "postal_code": "921183003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2437 FENTON ST STE A",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919143517",
            "telephone_number": "619-934-3240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TSENG",
        "first_name": "SUPAMAS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-19",
        "last_updated": "2016-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT291713",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chula Vista, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2016; 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.