Provider Demographics
NPI:1194847434
Name:MATHARU, RAJWINDER K (PT)
Entity Type:Individual
Prefix:
First Name:RAJWINDER
Middle Name:K
Last Name:MATHARU
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28035 AVENUE STANFORD
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-1104
Mailing Address - Country:US
Mailing Address - Phone:661-678-2629
Mailing Address - Fax:
Practice Address - Street 1:1893 MONTEREY HIGHWAY
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95112
Practice Address - Country:US
Practice Address - Phone:408-288-3800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-06
Last Update Date:2016-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY031448-1225100000X
NJ40QA01181600225100000X
CA41927225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist