Provider Demographics
NPI:1962602219
Name:GUNJA, FARHAT Z (PHYSICAL THERAPIST)
Entity type:Individual
Prefix:
First Name:FARHAT
Middle Name:Z
Last Name:GUNJA
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1398 ROLLING KNOLL RD
Mailing Address - Street 2:
Mailing Address - City:DIAMOND BAR
Mailing Address - State:CA
Mailing Address - Zip Code:91765-2638
Mailing Address - Country:US
Mailing Address - Phone:909-861-3514
Mailing Address - Fax:
Practice Address - Street 1:405 N GARFIELD AVE
Practice Address - Street 2:
Practice Address - City:MONTEREY PARK
Practice Address - State:CA
Practice Address - Zip Code:91754-1201
Practice Address - Country:US
Practice Address - Phone:626-280-4884
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-24
Last Update Date:2007-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT9793225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist