Provider Demographics
NPI:1841826534
Name:GHAI, SANJAY KRISHAN (DPT)
Entity type:Individual
Prefix:DR
First Name:SANJAY
Middle Name:KRISHAN
Last Name:GHAI
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:533 W DUNTON AVE
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92865-2146
Mailing Address - Country:US
Mailing Address - Phone:714-420-5767
Mailing Address - Fax:
Practice Address - Street 1:22 ODYSSEY STE 165
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-3194
Practice Address - Country:US
Practice Address - Phone:949-727-2192
Practice Address - Fax:949-727-2193
Is Sole Proprietor?:No
Enumeration Date:2020-03-13
Last Update Date:2021-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA298168225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist