Provider Demographics
NPI:1235349440
Name:BHACHU, GURDEV (RPT)
Entity Type:Individual
Prefix:
First Name:GURDEV
Middle Name:
Last Name:BHACHU
Suffix:
Gender:M
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5272 ALHAMBRA VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:MARTINEZ
Mailing Address - State:CA
Mailing Address - Zip Code:94553-9741
Mailing Address - Country:US
Mailing Address - Phone:925-370-0723
Mailing Address - Fax:
Practice Address - Street 1:1301 HILLTOP MALL RD
Practice Address - Street 2:B101
Practice Address - City:RICHMOND
Practice Address - State:CA
Practice Address - Zip Code:94806-1911
Practice Address - Country:US
Practice Address - Phone:510-222-8080
Practice Address - Fax:510-222-8083
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
12835225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist