Healthcare Provider Details

I. General information

NPI: 1508587551
Provider Name (Legal Business Name): PRESTON KUNWAR
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/08/2022
Last Update Date: 04/17/2026
Certification Date: 04/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 LOWER RAGSDALE DR
MONTEREY CA
93940-5827
US

IV. Provider business mailing address

8056 ST ANDREWS LN
STANLEY NC
28164-9714
US

V. Phone/Fax

Practice location:
  • Phone: 831-648-7200
  • Fax:
Mailing address:
  • Phone: 919-908-3920
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number304985
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: