Provider Demographics
NPI:1518404490
Name:KAHANDAL, RESHMA RAVIJIT (DPT)
Entity Type:Individual
Prefix:MS
First Name:RESHMA
Middle Name:RAVIJIT
Last Name:KAHANDAL
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:414 S CLOVERDALE AVE
Mailing Address - Street 2:APT 105
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90036-3467
Mailing Address - Country:US
Mailing Address - Phone:951-315-9339
Mailing Address - Fax:
Practice Address - Street 1:414 S CLOVERDALE AVE
Practice Address - Street 2:APT 105
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90036-3467
Practice Address - Country:US
Practice Address - Phone:951-315-9339
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-30
Last Update Date:2017-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35391225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist