Provider Demographics
NPI:1215225644
Name:KAPU, PUA (PHYSICAL THERAPY)
Entity Type:Individual
Prefix:
First Name:PUA
Middle Name:
Last Name:KAPU
Suffix:
Gender:F
Credentials:PHYSICAL THERAPY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5050 AVENIDA ENCINAS
Mailing Address - Street 2:SUITE # 250
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92008-4381
Mailing Address - Country:US
Mailing Address - Phone:760-729-5433
Mailing Address - Fax:619-308-6004
Practice Address - Street 1:5050 AVENIDA ENCINAS
Practice Address - Street 2:SUITE # 250
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92008-4381
Practice Address - Country:US
Practice Address - Phone:760-729-5433
Practice Address - Fax:619-308-6004
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-19
Last Update Date:2011-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 19632225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist