Provider Demographics
NPI:1124520879
Name:GLUPNGAM, MING-HSIANG (PT)
Entity type:Individual
Prefix:
First Name:MING-HSIANG
Middle Name:
Last Name:GLUPNGAM
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:MING-HSIANG
Other - Middle Name:KELLI
Other - Last Name:HSIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:5706 DAMON ST
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93063-4229
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3680 N MOORPARK RD
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360-2603
Practice Address - Country:US
Practice Address - Phone:805-496-9301
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-07
Last Update Date:2022-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist