NPIMap

Organization Active NPI

Pro Performance Physical Therapy, Inc.

  • Physical Therapist
  • Los Angeles, CA
National Provider Identifier
1952827198
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT25496 Issued in CA
Legal business name
PRO PERFORMANCE PHYSICAL THERAPY, INC.
Practice address
2738 Butler Ave
Los Angeles, CA 90064-3806
Phone
(909) 576-4389
NPI assigned
Aug 18, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Ms. Lisa Kwan, MSPTNPI 1982961496
Title
President
Phone
(909) 576-4389

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT25496 CA Primary

Addresses

Primary practice location

2738 Butler Ave
Los Angeles, CA 90064-3806

Mailing address

2740 Butler Ave
Los Angeles, CA 90064-3806
Phone (310) 351-1464

Other practice location 1

7037 La Tijera Blvd Apt E201
Los Angeles, CA 90045-2182
Phone (909) 576-4389

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1503014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1952827198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2740 BUTLER AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900643806",
            "telephone_number": "310-351-1464",
            "fax_number": "424-256-2300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2738 BUTLER AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900643806",
            "telephone_number": "909-576-4389"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7037 La Tijera Blvd Apt E201",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900452182",
            "country_code": "US",
            "telephone_number": "909-576-4389",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PRO PERFORMANCE PHYSICAL THERAPY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-18",
        "last_updated": "2022-07-21",
        "certification_date": "2021-07-12",
        "status": "A",
        "authorized_official_last_name": "KWAN",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "909-576-4389",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MSPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT25496",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.