Provider Demographics
NPI:1760830780
Name:KUNAL PATEL INC
Entity Type:Organization
Organization Name:KUNAL PATEL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:KUNAL
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:510-714-4288
Mailing Address - Street 1:3800 WALNUT AVE
Mailing Address - Street 2:APT 303B
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-2275
Mailing Address - Country:US
Mailing Address - Phone:510-714-4288
Mailing Address - Fax:
Practice Address - Street 1:3800 WALNUT AVE
Practice Address - Street 2:APT 303B
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-2275
Practice Address - Country:US
Practice Address - Phone:510-714-4288
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-31
Last Update Date:2016-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT37768261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy