Provider Demographics
NPI:1447965934
Name:BATTA, VIKAS KUMAR (OTR/L PAMS)
Entity type:Individual
Prefix:MR
First Name:VIKAS
Middle Name:KUMAR
Last Name:BATTA
Suffix:
Gender:M
Credentials:OTR/L PAMS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17106 STOWERS AVE
Mailing Address - Street 2:
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90703-1051
Mailing Address - Country:US
Mailing Address - Phone:602-687-0246
Mailing Address - Fax:
Practice Address - Street 1:17106 STOWERS AVE
Practice Address - Street 2:
Practice Address - City:CERRITOS
Practice Address - State:CA
Practice Address - Zip Code:90703-1051
Practice Address - Country:US
Practice Address - Phone:602-687-0246
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-18
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10205225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist