MEDICARE: HIMANI SOOD PT

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

General Provider Information

NPI Number	:	1679967178
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HIMANI SOOD PT

Provider Business Mailing Address
First Line	:	15237 BROOKSTONE ST
Second Line	:
City	:	FONTANA
State	:	CA
Zip	:	92336-4051
Country	:	US
Telephone Number	:	832-360-6396
Fax Number	:

Provider Business Practice Location Address
First Line	:	774 S PLACENTIA AVE STE 200
Second Line	:
City	:	PLACENTIA
State	:	CA
Zip	:	92870-6838
Country	:	US
Telephone Number	:	714-646-8904
Fax Number	:

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

Provider Enumeration Date	:	03/23/2015
Last Update Date	:	02/18/2021

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Directions to “ HIMANI SOOD PT” Practice Location

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