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Individual
PETE CHARUKESNANT
Active
Individual
PETE CHARUKESNANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
291104
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1053320325
TYPE2 NPI
CA
01
—
ZZZ29361Z
MEDICARE GROUP PTAN
CA
Enumeration date
03/22/2016
Last updated
01/03/2022
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