Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 36308 | CA |
N | 2251G0304X | Physical Therapist - Geriatrics | 36308 | CA |
N | 2251S0007X | Physical Therapist - Sports | 36308 | CA |
N | 2251X0800X | Physical Therapist - Orthopedic | 36308 | CA |
NPI | 1356671028 |
---|---|
Provider Name | Cindy Chunfat |
First Address | Novato, CA 94947-4131 |
Second Address | San Rafael, CA 94903-2702 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/12/2009 |
Last Update Date | 31/12/2009 |