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General NPI Number Information
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NPI Number | 1568782886
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Entity Type | Individual
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Provider Name | PALAK DAIVAK SHAH P.T.
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Gender | Female
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Dates
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Enumeration Date | 06/09/2010
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Last Update Date | 01/07/2025
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Provider Practice Location Address
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Address Line | 16185 LOS GATOS BLVD STE 205
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City | LOS GATOS
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State | CA
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Zip | 95032-4569
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Country | US
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Telephone | 408-823-1214
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Fax |
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Provider Business Mailing Address
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Address Line | 44190 BOITANO DR
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City | FREMONT
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State | CA
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Zip | 94539-6332
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Country | US
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Telephone | 408-823-1214
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT 36736
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License Number State | CA
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