Provider Demographics
NPI:1972193431
Name:GOHEL, PUJA
Entity Type:Individual
Prefix:
First Name:PUJA
Middle Name:
Last Name:GOHEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 POWELL ST STE 120
Mailing Address - Street 2:
Mailing Address - City:EMERYVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94608-1832
Mailing Address - Country:US
Mailing Address - Phone:818-667-0328
Mailing Address - Fax:
Practice Address - Street 1:2200 POWELL ST STE 120
Practice Address - Street 2:
Practice Address - City:EMERYVILLE
Practice Address - State:CA
Practice Address - Zip Code:94608-1832
Practice Address - Country:US
Practice Address - Phone:510-318-8600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-19
Last Update Date:2021-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XN1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistNeurorehabilitation