Healthcare Provider Details

I. General information

NPI: 1710912126
Provider Name (Legal Business Name): CHARLES E KRPATA PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 10/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26617 CARMEL CENTER PL
CARMEL CA
93923-8655
US

IV. Provider business mailing address

26617 CARMEL CENTER PL
CARMEL CA
93923-8655
US

V. Phone/Fax

Practice location:
  • Phone: 831-622-0599
  • Fax: 831-622-7599
Mailing address:
  • Phone: 831-622-0599
  • Fax: 831-622-7599

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT5548
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License NumberPT5548
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: