Provider Demographics
NPI:1588469092
Name:TRANG, TOMMY (DPT)
Entity type:Individual
Prefix:
First Name:TOMMY
Middle Name:
Last Name:TRANG
Suffix:
Gender:
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:842 IRIS WAY UNIT A
Mailing Address - Street 2:
Mailing Address - City:AZUSA
Mailing Address - State:CA
Mailing Address - Zip Code:91702-2499
Mailing Address - Country:US
Mailing Address - Phone:626-757-2171
Mailing Address - Fax:
Practice Address - Street 1:2550 N HOLLYWOOD WAY STE 100
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505-5015
Practice Address - Country:US
Practice Address - Phone:818-524-3730
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-18
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA307661225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist