Provider Demographics
NPI:1073874830
Name:BUSHAN, ARTHI (PT)
Entity Type:Individual
Prefix:
First Name:ARTHI
Middle Name:
Last Name:BUSHAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:ARTHI
Other - Middle Name:
Other - Last Name:VENKATAPATHY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:22 ODYSSEY STE 165
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-3194
Mailing Address - Country:US
Mailing Address - Phone:949-727-2192
Mailing Address - Fax:949-727-2193
Practice Address - Street 1:22 ODYSSEY STE 165
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-3194
Practice Address - Country:US
Practice Address - Phone:949-727-2192
Practice Address - Fax:949-727-2193
Is Sole Proprietor?:No
Enumeration Date:2012-06-07
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA303431225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist