Healthcare Provider Details

I. General information

NPI: 1669336814
Provider Name (Legal Business Name): BHAVIKA M MANIAR DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/12/2025
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10915 MAGNOLIA AVE
RIVERSIDE CA
92505-3044
US

IV. Provider business mailing address

11605 ALDERIDGE LN
SAN DIEGO CA
92131-3717
US

V. Phone/Fax

Practice location:
  • Phone: 951-554-5088
  • Fax:
Mailing address:
  • Phone: 858-414-1146
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number308555
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: