Provider Demographics
NPI:1215771381
Name:ANGLE PHYSICAL THERAPY CENTER
Entity type:Organization
Organization Name:ANGLE PHYSICAL THERAPY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:CHE-CHERNG
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:626-688-1762
Mailing Address - Street 1:123 E VALLEY BLVD STE 206
Mailing Address - Street 2:
Mailing Address - City:SAN GABRIEL
Mailing Address - State:CA
Mailing Address - Zip Code:91776-4702
Mailing Address - Country:US
Mailing Address - Phone:626-297-8998
Mailing Address - Fax:626-254-1588
Practice Address - Street 1:123 E VALLEY BLVD STE 206
Practice Address - Street 2:
Practice Address - City:SAN GABRIEL
Practice Address - State:CA
Practice Address - Zip Code:91776-4702
Practice Address - Country:US
Practice Address - Phone:626-297-8998
Practice Address - Fax:626-254-1588
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-24
Last Update Date:2024-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No171100000XOther Service ProvidersAcupuncturist
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy