Individual ProviderKim Ngoc NguyenPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address2039 Forest Ave, #104, San Jose, CA 95128-4817(408) 279-8501(408) 733-3670PECOS EnrollmentBased on the most recent information from CMS, provider Kim Ngoc Nguyen does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 4 days ago.Profile DetailsProvider ID1043659881Provider TypeIndividualFull NameNguyen, Kim NgocCredentialD.P.T.GenderFemaleSole ProprietorNoEnumeration Date6/14/2013Last Updated1/3/2022Contact InformationPractice LocationPractice Address2039 Forest Ave, #104, San Jose, CA 95128-4817Phone(408) 279-8501Fax(408) 279-8504Mailing LocationMailing Address246 Sobrante Way, Sunnyvale, CA 94086-4807Phone(408) 733-3670Fax(408) 245-7968Provider TaxonomiesCodeDescriptionLicenseCode225100000XPrimaryDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicensePT 40109California