Provider Demographics
NPI:1730721267
Name:CHAU, TANEY (PT, DPT)
Entity type:Individual
Prefix:
First Name:TANEY
Middle Name:
Last Name:CHAU
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:T.J.
Other - Middle Name:
Other - Last Name:CHAU
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:4224 S CENTINELA AVE APT 207
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90066-2623
Mailing Address - Country:US
Mailing Address - Phone:541-760-2439
Mailing Address - Fax:
Practice Address - Street 1:6801 PARK TER
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90045-1543
Practice Address - Country:US
Practice Address - Phone:310-665-7100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-16
Last Update Date:2019-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA297272208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation