Provider Demographics
NPI:1124091525
Name:PATEL, DHARMESH S (PT)
Entity type:Individual
Prefix:
First Name:DHARMESH
Middle Name:S
Last Name:PATEL
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 N ARROWHEAD AVE
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92405-4002
Mailing Address - Country:US
Mailing Address - Phone:909-882-9822
Mailing Address - Fax:909-882-1388
Practice Address - Street 1:2100 N ARROWHEAD AVE
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92405-4002
Practice Address - Country:US
Practice Address - Phone:909-882-9822
Practice Address - Fax:909-882-1388
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-08
Last Update Date:2016-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT28814225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist