Organization
FM PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FAYEZA MULLAMITHAWALA P.T. (P.T.)
(650) 868-8286
Entity
Organization
Contact information
Practice address
587 KINGSTON RD, BELMONT, CA 94002-2319
(650) 868-8286
Mailing address
587 KINGSTON RD, BELMONT, CA 94002-2319
(650) 868-8286
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
PT 28154
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT28154
PT LICENSE NUMBER
CA
Enumeration date
10/08/2006
Last updated
08/22/2020
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