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

Bong Su Jang, DPT

Individual provider Physical Therapist · NPI 1255961850

Bong Su Jang, DPT is a Physical Therapist in Private Practice in San Clemente, California. Qualified in 2019, 7 years ago. Practices with California Luna Care Physical Therapy PC, a 773-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
7
Licensed in
CA
In the registry since
2020
What do these letters mean?
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

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Practice location Address checks out

415 E Avenida Pico Ste M
San Clemente, CA 92672-3800
Phone: (949) 245-6581
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence PT296936 (CA)

Record details

NPI number1255961850
Entity typeIndividual (Type 1)
GenderMale
Credentials DPT
Sole proprietorYes
NPI enumeratedJanuary 22, 2020
Last updated in NPPESAugust 8, 2022
Certification dateAugust 8, 2022

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice California Luna Care Physical Therapy Pc — 773 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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