Provider Demographics
NPI:1891361663
Name:OT PARK OCCUPATIONAL AND PHYSICAL THERAPY INC
Entity Type:Organization
Organization Name:OT PARK OCCUPATIONAL AND PHYSICAL THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER AND CEO
Authorized Official - Prefix:
Authorized Official - First Name:HIRAL
Authorized Official - Middle Name:
Authorized Official - Last Name:KHATRI
Authorized Official - Suffix:
Authorized Official - Credentials:OTD, OTR/L
Authorized Official - Phone:408-607-9967
Mailing Address - Street 1:284 DIGITAL DR
Mailing Address - Street 2:
Mailing Address - City:MORGAN HILL
Mailing Address - State:CA
Mailing Address - Zip Code:95037-2877
Mailing Address - Country:US
Mailing Address - Phone:408-607-9967
Mailing Address - Fax:
Practice Address - Street 1:284 DIGITAL DR
Practice Address - Street 2:
Practice Address - City:MORGAN HILL
Practice Address - State:CA
Practice Address - Zip Code:95037-2877
Practice Address - Country:US
Practice Address - Phone:086-079-9674
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-02
Last Update Date:2021-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty