Healthcare Provider Details

I. General information

NPI: 1932016219
Provider Name (Legal Business Name): KALUA KINETIC PHYSICAL THERAPY, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4904 BUFFALO GULCH RD
MIDPINES CA
95345-9745
US

IV. Provider business mailing address

PO BOX 1183
MARIPOSA CA
95338-1183
US

V. Phone/Fax

Practice location:
  • Phone: 707-800-9742
  • Fax:
Mailing address:
  • Phone: 707-800-9742
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. MICAH KALUA
Title or Position: CEO
Credential: DPT
Phone: 707-339-0309