Basic Information
| Provider Information | |||||||||
| NPI: | 1548822992 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PARIKH | ||||||||
| FirstName: | HARDIK | ||||||||
| MiddleName: | D | ||||||||
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| Mailing Information | |||||||||
| Address1: | 412 HAVENWOOD CT | ||||||||
| Address2: | |||||||||
| City: | VACAVILLE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 956889271 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7073019354 | ||||||||
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| Practice Location | |||||||||
| Address1: | 585 NUT TREE CT # 95687 | ||||||||
| Address2: | |||||||||
| City: | VACAVILLE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 956873353 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7074498000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/06/2019 | ||||||||
| LastUpdateDate: | 07/06/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225200000X | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapy Assistant |
No ID Information.