Provider Demographics
NPI:1134254352
Name:KVAREKVAAL, TORHILD E (PT)
Entity type:Individual
Prefix:
First Name:TORHILD
Middle Name:E
Last Name:KVAREKVAAL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10459 MOUNTAIN VIEW AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:LOMA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92354-2033
Mailing Address - Country:US
Mailing Address - Phone:909-478-9508
Mailing Address - Fax:909-478-9518
Practice Address - Street 1:10459 MOUNTAIN VIEW AVE
Practice Address - Street 2:SUITE B
Practice Address - City:LOMA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92354-2033
Practice Address - Country:US
Practice Address - Phone:909-478-9508
Practice Address - Fax:909-478-9518
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2013-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22004225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CABK870ZMedicare PIN
CAZZZ30106ZMedicare PIN
CAOPT220040Medicare PIN
CACA102771Medicare PIN
CAZZZ23993ZMedicare PIN