Provider Demographics
NPI:1568425155
Name:WORAH, ANUPAMA MINIR (PT)
Entity Type:Individual
Prefix:
First Name:ANUPAMA
Middle Name:MINIR
Last Name:WORAH
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2441 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:LAGUNA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92651
Mailing Address - Country:US
Mailing Address - Phone:949-497-8699
Mailing Address - Fax:714-546-3811
Practice Address - Street 1:3093 S HARBOR BLVD
Practice Address - Street 2:ORTHOPAEDIC AND SPINE CARE PHYSICAL THERAPY
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92704-6448
Practice Address - Country:US
Practice Address - Phone:714-546-0811
Practice Address - Fax:714-546-3811
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20922225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WPT20922AMedicare ID - Type Unspecified