Provider Demographics
NPI:1659881688
Name:JAVIA, PURVI CHANDRESH (DPT)
Entity Type:Individual
Prefix:
First Name:PURVI
Middle Name:CHANDRESH
Last Name:JAVIA
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:PURVI
Other - Middle Name:PURUSHOTTAM
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:41 ROYAL VICTORIA
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92606-1919
Mailing Address - Country:US
Mailing Address - Phone:949-903-6925
Mailing Address - Fax:
Practice Address - Street 1:41 ROYAL VICTORIA
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92606-1919
Practice Address - Country:US
Practice Address - Phone:949-903-6925
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-04
Last Update Date:2017-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT32704225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist