Provider Demographics
NPI:1871465864
Name:CHAU, PRESTON CHUN-SUM (PT, DPT)
Entity type:Individual
Prefix:
First Name:PRESTON
Middle Name:CHUN-SUM
Last Name:CHAU
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11478 WINDING RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92131-2943
Mailing Address - Country:US
Mailing Address - Phone:858-366-2663
Mailing Address - Fax:
Practice Address - Street 1:590 S FAIR OAKS AVE # 110
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-2614
Practice Address - Country:US
Practice Address - Phone:818-369-7620
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-19
Last Update Date:2025-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA308966225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist