Smita Pankaj Ajmera, RPT
Individual provider Active NPI Physical Therapy Clinic/Center · Fremont, CA
NPI 1972849495 · NPPES record last updated Jan 2, 2013
Key facts
- NPI
- 1972849495
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Clinic/Center 261QP2000X
- License
- PT 16073 (CA)
- Practice address
- 3550 Mowry Ave
Suite 101
Fremont, CA 94538-1460 - Phone
- (510) 676-4087
- Fax
- (510) 745-0192
- NPI assigned
- Jan 2, 2013
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT 16073 | CA | MD | Physical Therapy Clinic/Center |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Clinic/Center | 261QP2000X | PT 16073 | CA | Yes |
Addresses
Primary practice location
3550 Mowry Ave
Suite 101
Fremont, CA 94538-1460
Mailing address
34346 Agate Ter
Fremont, CA 94555-3858
Phone (510) 676-4087
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All providers in Fremont, CA · Physical Therapy Clinic/Center in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 2, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.