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General NPI Number Information
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NPI Number | 1922672096
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Entity Type | Individual
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Provider Name | ANITHA SUBHASH
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Gender | Female
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Dates
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Enumeration Date | 05/13/2021
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Last Update Date | 11/06/2023
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Provider Practice Location Address
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Address Line | 12478 SALMON RIVER RD
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City | SAN DIEGO
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State | CA
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Zip | 92129-3545
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Country | US
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Telephone | 858-776-1808
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Fax |
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Provider Business Mailing Address
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Address Line | CALIFORNIA LUNA CARE PHYSICAL THERAPY 16185 SUIT 205
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City | LOS GATOS
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State | CA
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Zip | 95032-3545
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Country | US
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Telephone | 916-666-6678
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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 | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | PT32931
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 32931
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License Number State | CA
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