Provider Demographics
NPI:1376526525
Name:ELIAV-MEIRI, ORNA (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:
First Name:ORNA
Middle Name:
Last Name:ELIAV-MEIRI
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 WINWARD WAY
Mailing Address - Street 2:101
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94404-2469
Mailing Address - Country:US
Mailing Address - Phone:650-571-6800
Mailing Address - Fax:650-571-1260
Practice Address - Street 1:2001 WINWARD WAY
Practice Address - Street 2:101
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94404-2499
Practice Address - Country:US
Practice Address - Phone:650-571-6800
Practice Address - Fax:650-571-1260
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-22
Last Update Date:2012-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT29365225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAOPT296540Medicare ID - Type Unspecified