Provider Demographics
NPI:1366006447
Name:SHAH, PARITA VIPUL (PT DPT)
Entity Type:Individual
Prefix:
First Name:PARITA
Middle Name:VIPUL
Last Name:SHAH
Suffix:
Gender:F
Credentials:PT DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 SPECTACLE
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-1375
Mailing Address - Country:US
Mailing Address - Phone:909-313-6433
Mailing Address - Fax:
Practice Address - Street 1:26700 TOWNE CENTRE DR STE 120
Practice Address - Street 2:
Practice Address - City:FOOTHILL RANCH
Practice Address - State:CA
Practice Address - Zip Code:92610-2843
Practice Address - Country:US
Practice Address - Phone:949-597-2103
Practice Address - Fax:949-597-2061
Is Sole Proprietor?:No
Enumeration Date:2019-04-24
Last Update Date:2023-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA300956225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist