Provider Demographics
NPI:1871648725
Name:GULVADY, UMA PRADEEP (RPT)
Entity Type:Individual
Prefix:MS
First Name:UMA
Middle Name:PRADEEP
Last Name:GULVADY
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21725 AGAJANIAN LN
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:91350-3972
Mailing Address - Country:US
Mailing Address - Phone:661-296-0781
Mailing Address - Fax:661-296-0952
Practice Address - Street 1:21725 AGAJANIAN LN
Practice Address - Street 2:
Practice Address - City:SANTA CLARITA
Practice Address - State:CA
Practice Address - Zip Code:91350-3972
Practice Address - Country:US
Practice Address - Phone:661-296-0781
Practice Address - Fax:661-296-0952
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT17486225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPT17486Medicare ID - Type UnspecifiedPHYSICAL THERAPIST