Provider Demographics
NPI:1164870499
Name:BHUVANESWARAN, KARTHIKEYAN (DO)
Entity Type:Individual
Prefix:
First Name:KARTHIKEYAN
Middle Name:
Last Name:BHUVANESWARAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11873 VALLEY VIEW ST UNIT 1065
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92845-1236
Mailing Address - Country:US
Mailing Address - Phone:802-327-3422
Mailing Address - Fax:
Practice Address - Street 1:7601 IMPERIAL HWY
Practice Address - Street 2:
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90242-3456
Practice Address - Country:US
Practice Address - Phone:562-385-6468
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-26
Last Update Date:2023-09-14
Deactivation Date:2018-03-13
Deactivation Code:
Reactivation Date:2018-06-14
Provider Licenses
StateLicense IDTaxonomies
CA158482081N0008X, 2081N0008X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081N0008XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationNeuromuscular MedicineGroup - Multi-Specialty