Provider Demographics
NPI:1437179934
Name:BHARATWAL, BIPIN B (MD)
Entity Type:Individual
Prefix:DR
First Name:BIPIN
Middle Name:B
Last Name:BHARATWAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11728 DOROTHY ST
Mailing Address - Street 2:APT 309
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90049-5560
Mailing Address - Country:US
Mailing Address - Phone:310-709-2553
Mailing Address - Fax:
Practice Address - Street 1:11728 DOROTHY ST
Practice Address - Street 2:APT 309
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90049-5560
Practice Address - Country:US
Practice Address - Phone:310-709-2553
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA849212081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine