Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2251N0400X | Physical Therapist - Neurology | 291415 | CA |
Y | 2251X0800X | Physical Therapist - Orthopedic | 291415 | CA |
NPI | 1659728707 |
---|---|
Provider Name | Vidhi Vadera |
First Address | Oakland, CA 94611-2809 |
Second Address | Oakland, CA 94611-2809 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2016 |
Last Update Date | 18/05/2016 |