Provider Demographics
NPI:1396091393
Name:BATHIJA, MADHUMALA TILWANI (PT)
Entity type:Individual
Prefix:
First Name:MADHUMALA
Middle Name:TILWANI
Last Name:BATHIJA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:MADHUMALA
Other - Middle Name:NANDLAL
Other - Last Name:TILWANI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:15255 HEATHER STONE CT
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92127-3703
Mailing Address - Country:US
Mailing Address - Phone:214-789-3833
Mailing Address - Fax:
Practice Address - Street 1:15255 HEATHER STONE CT
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92127-3703
Practice Address - Country:US
Practice Address - Phone:858-633-3212
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-27
Last Update Date:2024-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA37329225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist