Provider Demographics
NPI:1184946543
Name:BOPARAI, KIRANDEEP K (PT)
Entity type:Individual
Prefix:
First Name:KIRANDEEP
Middle Name:K
Last Name:BOPARAI
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 1:1866 ROLLING ROCK CT
Mailing Address - Street 2:
Mailing Address - City:YUBA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95993-1425
Mailing Address - Country:US
Mailing Address - Phone:530-923-7172
Mailing Address - Fax:
Practice Address - Street 1:1110 CIVIC CENTER BLVD STE 502
Practice Address - Street 2:
Practice Address - City:YUBA CITY
Practice Address - State:CA
Practice Address - Zip Code:95993-3015
Practice Address - Country:US
Practice Address - Phone:530-671-7977
Practice Address - Fax:530-671-6163
Is Sole Proprietor?:No
Enumeration Date:2010-02-25
Last Update Date:2019-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA27737225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist