Provider Demographics
NPI:1366689952
Name:A K BHATTACHARYYA M D INC
Entity Type:Organization
Organization Name:A K BHATTACHARYYA M D INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALOK
Authorized Official - Middle Name:K
Authorized Official - Last Name:BHATTACHARYYA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:510-791-2442
Mailing Address - Street 1:PO BOX 14211
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94539-1511
Mailing Address - Country:US
Mailing Address - Phone:510-791-2442
Mailing Address - Fax:
Practice Address - Street 1:1900 MOWRY AVE STE 301
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-1722
Practice Address - Country:US
Practice Address - Phone:510-791-2442
Practice Address - Fax:510-791-2603
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-19
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA0A422572084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty