MEDICARE: RIMA BAJANIYA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	33348	CA

General Provider Information

NPI Number	:	1407244809
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RIMA BAJANIYA

Provider Business Mailing Address
First Line	:	18518 MANSEL AVE
Second Line	:
City	:	REDONDO BEACH
State	:	CA
Zip	:	90278-4643
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	18518 MANSEL AVE
Second Line	:
City	:	REDONDO BEACH
State	:	CA
Zip	:	90278-4643
Country	:	US
Telephone Number	:	310-371-2431
Fax Number	:	310-214-9167

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/07/2015
Last Update Date	:	01/07/2015

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