MEDICARE: PARKASH GABRIEL LALWANI

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	302761	CA

General Provider Information

NPI Number	:	1811695752
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PARKASH GABRIEL LALWANI

Provider Business Mailing Address
First Line	:	8583 AERO DR APT 3031
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92123-1651
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8583 AERO DR APT 3031
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92123-1651
Country	:	US
Telephone Number	:	619-515-2545
Fax Number	:

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

Provider Enumeration Date	:	02/20/2023
Last Update Date	:	12/13/2024

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