Healthcare Provider Details

I. General information

NPI: 1225545494
Provider Name (Legal Business Name): GAURI VARMA-CHUHAN PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/09/2018
Last Update Date: 01/09/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24422 AVENIDA DE LA CARLOTA STE 190
LAGUNA HILLS CA
92653-3634
US

IV. Provider business mailing address

24422 AVENIDA DE LA CARLOTA STE 190
LAGUNA HILLS CA
92653-3634
US

V. Phone/Fax

Practice location:
  • Phone: 949-340-6927
  • Fax:
Mailing address:
  • Phone: 949-340-6927
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberPTA5800
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: