Provider Demographics
NPI:1043895972
Name:HASSANSHAHI, MARAL (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:MARAL
Middle Name:
Last Name:HASSANSHAHI
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1008 CAROLAN AVE APT 1318
Mailing Address - Street 2:
Mailing Address - City:BURLINGAME
Mailing Address - State:CA
Mailing Address - Zip Code:94010-2699
Mailing Address - Country:US
Mailing Address - Phone:202-790-2938
Mailing Address - Fax:650-288-6883
Practice Address - Street 1:1008 CAROLAN AVE APT 1318
Practice Address - Street 2:
Practice Address - City:BURLINGAME
Practice Address - State:CA
Practice Address - Zip Code:94010-2699
Practice Address - Country:US
Practice Address - Phone:202-790-2938
Practice Address - Fax:650-288-6883
Is Sole Proprietor?:No
Enumeration Date:2021-03-11
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA302263225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist