Provider Demographics
NPI:1295479269
Name:VIRK, KAMALJEET KAUR
Entity type:Individual
Prefix:
First Name:KAMALJEET
Middle Name:KAUR
Last Name:VIRK
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 1:335 SYCAMORE GROVE ST
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93065-7344
Mailing Address - Country:US
Mailing Address - Phone:805-298-6652
Mailing Address - Fax:
Practice Address - Street 1:1236 ERRINGER RD
Practice Address - Street 2:
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93065-4502
Practice Address - Country:US
Practice Address - Phone:800-967-4667
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-25
Last Update Date:2022-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist