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General NPI Number Information
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NPI Number | 1114676269
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Entity Type | Individual
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Provider Name | MRS. RAJINI R MUNAGALA
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Gender | Female
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Dates
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Enumeration Date | 03/23/2022
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Last Update Date | 03/23/2022
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Provider Practice Location Address
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Address Line | 2500. PARK SIDE DRIVE
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City | FREMONT
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State | CA
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Zip | 94536
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Country | US
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Telephone | 510-992-4242
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Fax |
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Provider Business Mailing Address
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Address Line | 181 BLACK MOUNTAIN CIR
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City | FREMONT
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State | CA
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Zip | 94536-6582
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | AT-9093
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License Number State | CA
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