Active NPI
Jimmy Quach
- Physical Therapist
- La Puente, CA
National Provider Identifier
1972186039
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT299935
- Practice address
- 656 Greycliff Ave
La Puente, CA 91744-3103 - Phone
- (626) 216-2816
- NPI assigned
- May 5, 2021
- 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 | PT299935 | CA | Primary |
Addresses
Primary practice location
656 Greycliff Ave
La Puente, CA 91744-3103
Mailing address
656 Greycliff Ave
La Puente, CA 91744-3103
Phone (626) 216-2816
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT299935 | CA | MD | Physical Therapist |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1620172800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1620172800000",
"number": "1972186039",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "656 GREYCLIFF AVE",
"city": "LA PUENTE",
"state": "CA",
"postal_code": "917443103",
"telephone_number": "626-216-2816"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "656 GREYCLIFF AVE",
"city": "LA PUENTE",
"state": "CA",
"postal_code": "917443103",
"telephone_number": "626-216-2816"
}
],
"practiceLocations": [],
"basic": {
"last_name": "QUACH",
"first_name": "JIMMY",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-05-05",
"last_updated": "2021-05-05",
"certification_date": "2021-05-05",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "PT299935",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in La Puente, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.