MEDICARE: RENU JOSHI PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PT13080	CA

General Provider Information

NPI Number	:	1922401801
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RENU JOSHI PT

Provider Business Mailing Address
First Line	:	PO BOX 9593
Second Line	:
City	:	RANCHO SANTA FE
State	:	CA
Zip	:	92067-4593
Country	:	US
Telephone Number	:	510-517-6291
Fax Number	:

Provider Business Practice Location Address
First Line	:	4411 30TH ST STE 100
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92116-4286
Country	:	US
Telephone Number	:	619-261-6049
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/06/2014
Last Update Date	:	05/14/2021

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