Provider Demographics
NPI:1851053177
Name:RANOA, KEITH (PT, DPT)
Entity Type:Individual
Prefix:
First Name:KEITH
Middle Name:
Last Name:RANOA
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38240 LOGAN DR
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94536-5902
Mailing Address - Country:US
Mailing Address - Phone:510-449-5326
Mailing Address - Fax:
Practice Address - Street 1:38240 LOGAN DR
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94536-5902
Practice Address - Country:US
Practice Address - Phone:510-449-5326
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-13
Last Update Date:2021-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist