Provider Demographics
NPI:1316559149
Name:SHAMPUR, RASHMI (DPT)
Entity Type:Individual
Prefix:
First Name:RASHMI
Middle Name:
Last Name:SHAMPUR
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:RASHMI
Other - Middle Name:
Other - Last Name:BHEEMANNA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:1401 CAMBRIA CT
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92374-2794
Mailing Address - Country:US
Mailing Address - Phone:216-262-4708
Mailing Address - Fax:
Practice Address - Street 1:1455 FORD ST STE 104
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92373-3904
Practice Address - Country:US
Practice Address - Phone:909-255-0611
Practice Address - Fax:909-798-1317
Is Sole Proprietor?:No
Enumeration Date:2020-08-22
Last Update Date:2021-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY04445701225100000X
CA299705225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist