Provider Demographics
NPI:1386261063
Name:YUNG-EN PERNG
Entity type:Organization
Organization Name:YUNG-EN PERNG
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YUNG-EN
Authorized Official - Middle Name:
Authorized Official - Last Name:PERNG
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:949-331-4689
Mailing Address - Street 1:1241 SOLANO AVE APT 24
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:CA
Mailing Address - Zip Code:94706-1742
Mailing Address - Country:US
Mailing Address - Phone:949-331-4689
Mailing Address - Fax:
Practice Address - Street 1:1241 SOLANO AVE APT 24
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:CA
Practice Address - Zip Code:94706-1742
Practice Address - Country:US
Practice Address - Phone:949-331-4689
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-29
Last Update Date:2020-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty