Provider Demographics
NPI:1316955289
Name:DESAI, DRASHTI D (MPT)
Entity type:Individual
Prefix:
First Name:DRASHTI
Middle Name:D
Last Name:DESAI
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:DRASHTI
Other - Middle Name:D
Other - Last Name:DESAI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MPT
Mailing Address - Street 1:2128 WILD FLOWER LN
Mailing Address - Street 2:
Mailing Address - City:CHINO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91709-1717
Mailing Address - Country:US
Mailing Address - Phone:909-628-2968
Mailing Address - Fax:
Practice Address - Street 1:14726 RAMONA AVE STE 100
Practice Address - Street 2:
Practice Address - City:CHINO
Practice Address - State:CA
Practice Address - Zip Code:91710-5784
Practice Address - Country:US
Practice Address - Phone:909-606-8220
Practice Address - Fax:909-606-8050
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 26052225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist