Provider Demographics
NPI:1386317634
Name:GAN, JOHN PATRICK DUNGCA (DPT)
Entity type:Individual
Prefix:DR
First Name:JOHN PATRICK
Middle Name:DUNGCA
Last Name:GAN
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11340 EMELITA ST
Mailing Address - Street 2:
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91601-1226
Mailing Address - Country:US
Mailing Address - Phone:702-580-7489
Mailing Address - Fax:
Practice Address - Street 1:616 S WESTMORELAND AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90005-3967
Practice Address - Country:US
Practice Address - Phone:818-934-0616
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-30
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty