Provider Demographics
NPI:1972513620
Name:DESAI, DEVAL KUSHANG (PT)
Entity type:Individual
Prefix:
First Name:DEVAL
Middle Name:KUSHANG
Last Name:DESAI
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:DEVAL
Other - Middle Name:MADHUSUDAN
Other - Last Name:PARIKH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:14218 VIA MICHELANGELO
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92129-4200
Mailing Address - Country:US
Mailing Address - Phone:858-232-9822
Mailing Address - Fax:858-536-9461
Practice Address - Street 1:9265 ACTIVITY RD STE 107
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92126-4444
Practice Address - Country:US
Practice Address - Phone:858-344-5586
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501012198225100000X
CAPT32733225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist