Provider Demographics
NPI:1639498983
Name:BHUPTANI, KEYA DANI (PT)
Entity Type:Individual
Prefix:MS
First Name:KEYA
Middle Name:DANI
Last Name:BHUPTANI
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:KEYA
Other - Middle Name:AJAY
Other - Last Name:DANI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1000 FREMONT AVE STE 108
Mailing Address - Street 2:
Mailing Address - City:LOS ALTOS
Mailing Address - State:CA
Mailing Address - Zip Code:94024-6054
Mailing Address - Country:US
Mailing Address - Phone:650-947-8500
Mailing Address - Fax:650-947-8501
Practice Address - Street 1:1000 FREMONT AVE STE 108
Practice Address - Street 2:
Practice Address - City:LOS ALTOS
Practice Address - State:CA
Practice Address - Zip Code:94024-6054
Practice Address - Country:US
Practice Address - Phone:650-947-8500
Practice Address - Fax:650-947-8501
Is Sole Proprietor?:No
Enumeration Date:2010-05-26
Last Update Date:2019-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY032575-1225100000X
MD23989225100000X
CAPT411012251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist