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General NPI Number Information
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NPI Number | 1821886433
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Entity Type | Individual
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Provider Name | RINA RUSHABH SHAH PTA,CLT
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Gender | Female
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Dates
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Enumeration Date | 04/25/2025
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Last Update Date | 04/25/2025
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Provider Practice Location Address
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Address Line | 14971 BROOKTREE ST
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City | CORONA
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State | CA
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Zip | 92880-3934
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Country | US
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Telephone | 714-726-7561
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Fax |
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Provider Business Mailing Address
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Address Line | 14971 BROOKTREE ST
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City | CORONA
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State | CA
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Zip | 92880-3934
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Country | US
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Telephone | 714-726-7561
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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 | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 9386
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License Number State | CA
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