Provider Demographics
NPI:1245218924
Name:BISARYA, PUSHPA (MD)
Entity Type:Individual
Prefix:DR
First Name:PUSHPA
Middle Name:
Last Name:BISARYA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4900 CALIFORNIA AVE STE 400B
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309-7081
Mailing Address - Country:US
Mailing Address - Phone:661-459-1900
Mailing Address - Fax:661-459-1944
Practice Address - Street 1:1507 PANAMA LN STE G1001507
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93307-5682
Practice Address - Country:US
Practice Address - Phone:866-707-6664
Practice Address - Fax:661-746-9197
Is Sole Proprietor?:No
Enumeration Date:2006-01-04
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036065771207P00000X
CAC128327207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine