Provider Demographics
NPI:1003554155
Name:VORA, AVANI ASHWIN
Entity Type:Individual
Prefix:
First Name:AVANI
Middle Name:ASHWIN
Last Name:VORA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:430 MONTAGUE EXPY UNIT 20
Mailing Address - Street 2:
Mailing Address - City:MILPITAS
Mailing Address - State:CA
Mailing Address - Zip Code:95035-6839
Mailing Address - Country:US
Mailing Address - Phone:510-990-1718
Mailing Address - Fax:
Practice Address - Street 1:500 E CALAVERAS BLVD STE 112
Practice Address - Street 2:
Practice Address - City:MILPITAS
Practice Address - State:CA
Practice Address - Zip Code:95035-7708
Practice Address - Country:US
Practice Address - Phone:408-934-4700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-26
Last Update Date:2022-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT296579225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist