Provider Demographics
NPI:1326665886
Name:KULKARNI, POORVA (PT DPT MHS)
Entity Type:Individual
Prefix:
First Name:POORVA
Middle Name:
Last Name:KULKARNI
Suffix:
Gender:F
Credentials:PT DPT MHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6705 MAGNETIC LOOP
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95119-1757
Mailing Address - Country:US
Mailing Address - Phone:317-829-4288
Mailing Address - Fax:
Practice Address - Street 1:15585 MONTEREY RD STE D
Practice Address - Street 2:
Practice Address - City:MORGAN HILL
Practice Address - State:CA
Practice Address - Zip Code:95037-5460
Practice Address - Country:US
Practice Address - Phone:669-377-1133
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-01
Last Update Date:2020-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA42221208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation