Pankita Intwala, BPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

292811 Issued in CA

Practice address

555 Mowry Ave
Suite E
Fremont, CA 94536-4110

Phone

(510) 745-7700

Fax

(510) 279-4300

NPI assigned

Feb 13, 2017

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1486944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486944000000",
    "number": "1619416450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39120 ARGONAUT WAY",
            "address_2": "274",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945381304",
            "telephone_number": "510-745-7700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 MOWRY AVE",
            "address_2": "SUITE E",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945364110",
            "telephone_number": "510-745-7700",
            "fax_number": "510-279-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INTWALA",
        "first_name": "PANKITA",
        "credential": "BPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-13",
        "last_updated": "2017-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "292811",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAL THERAPY BOARD OF CALIFORNIA",
            "identifier": "292811",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Fremont, CA
• Providers in Fremont, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.