Healthcare Provider Details

I. General information

NPI: 1568698751
Provider Name (Legal Business Name): NEHA PHYSICAL THERAPY AND YOGA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2009
Last Update Date: 12/21/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8420 WILSHIRE BLVD
BEVERLY HILLS CA
90211-3201
US

IV. Provider business mailing address

608 STRAND ST #8
SANTA MONICA CA
90405-2497
US

V. Phone/Fax

Practice location:
  • Phone: 310-659-9911
  • Fax: 323-852-7105
Mailing address:
  • Phone: 310-659-9911
  • Fax: 323-852-7105

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number28974
License Number StateCA

VIII. Authorized Official

Name: MRS. NEHA SHAH
Title or Position: OWNER
Credential: MPT
Phone: 310-659-9911