Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Andre Phonpradith

Individual provider Physical Therapist · NPI 1609685304

Andre Phonpradith is a Physical Therapist in Private Practice in Downey, California. Qualified in 2024, 2 years ago. Practices with Southern California Permanente Medical Group, an 11,242-clinician group and accepts Medicare assignment.

Years since qualifying
2
In the registry since
2025
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Practice location Address checks out

9353 Imperial Hwy
Downey, CA 90242-2812
Phone: (562) 657-4110
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X

Record details

NPI number1609685304
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJanuary 6, 2025
Last updated in NPPESJune 27, 2025
Certification dateJanuary 6, 2025
Mailing address10651 Hedlund Dr, Anaheim, CA 92804-5929

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Southern California Permanente Medical Group — 11242 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Downey