Michael Wong PT a Professional Corporation

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT20628 Issued in CA

Legal business name

MICHAEL WONG PT A PROFESSIONAL CORPORATION

Practice address

206 E Las Tunas Dr
Suite 5
San Gabriel, CA 91776-1411

Phone

(626) 660-6080

NPI assigned

Jan 3, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Michael Wong, PT

Title

Owner

Phone

(626) 660-6080

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418688000000",
    "number": "1922165257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 E LAS TUNAS DR",
            "address_2": "SUITE 5",
            "city": "SAN GABRIEL",
            "state": "CA",
            "postal_code": "917761411",
            "telephone_number": "626-660-6080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 E LAS TUNAS DR",
            "address_2": "SUITE 5",
            "city": "SAN GABRIEL",
            "state": "CA",
            "postal_code": "917761411",
            "telephone_number": "626-660-6080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL WONG PT A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-03",
        "last_updated": "2014-12-16",
        "status": "A",
        "authorized_official_last_name": "WONG",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "626-660-6080",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT20628",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in San Gabriel, CA
• Providers in San Gabriel, 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 16, 2014; 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.