Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | PT26543 | CA |
NPI | 1306917133 |
---|---|
Provider Name | Dr. Sapan Naresh Palkhiwala |
First Address | Laguna Hills, CA 92653-7602 |
Second Address | Laguna Hills, CA 92653-7602 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/11/2006 |
Last Update Date | 01/02/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
Q63152 | (02) | CA |
WPT26543A | PPIN (01) | CA |