Provider Demographics
NPI:1326422874
Name:DANI, MRUGA
Entity Type:Individual
Prefix:MRS
First Name:MRUGA
Middle Name:
Last Name:DANI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1590 OAKLAND RD STE B102
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95131-2444
Mailing Address - Country:US
Mailing Address - Phone:315-420-0523
Mailing Address - Fax:
Practice Address - Street 1:1590 OAKLAND RD STE B102
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95131-2444
Practice Address - Country:US
Practice Address - Phone:315-420-0523
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-15
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA43039225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist