Provider Demographics
NPI:1861597379
Name:PATEL, KRUTIKA G (PT)
Entity type:Individual
Prefix:MRS
First Name:KRUTIKA
Middle Name:G
Last Name:PATEL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MRS
Other - First Name:KATIE
Other - Middle Name:
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT
Mailing Address - Street 1:3727 BUCHANAN ST
Mailing Address - Street 2:#205
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94123
Mailing Address - Country:US
Mailing Address - Phone:415-593-2532
Mailing Address - Fax:415-593-7974
Practice Address - Street 1:3727 BUCHANAN ST
Practice Address - Street 2:#205
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94123
Practice Address - Country:US
Practice Address - Phone:415-593-2532
Practice Address - Fax:415-593-7974
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT24653225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OPT246530Medicare ID - Type Unspecified