Provider Demographics
NPI:1619900628
Name:SALEHI, SETAREH (PHYSICAL THERAPIEST)
Entity Type:Individual
Prefix:MRS
First Name:SETAREH
Middle Name:
Last Name:SALEHI
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIEST
Other - Prefix:MRS
Other - First Name:SETAREH
Other - Middle Name:
Other - Last Name:BARKHORDAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHYSICAL THERAPIEST
Mailing Address - Street 1:23412 MOULTON PKWY
Mailing Address - Street 2:SUITE 120
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-1732
Mailing Address - Country:US
Mailing Address - Phone:949-855-3926
Mailing Address - Fax:949-829-0221
Practice Address - Street 1:23412 MOULTON PKWY
Practice Address - Street 2:SUITE 120
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-1732
Practice Address - Country:US
Practice Address - Phone:949-855-3926
Practice Address - Fax:949-829-0221
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT18387225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA5516163OtherCCN
CAZZZ0886ZOtherBLUE SHIELD
CAZZZ0886ZOtherBLUE SHIELD