Provider Demographics
NPI:1437231537
Name:MALIK, BHAVNA (MD)
Entity Type:Individual
Prefix:DR
First Name:BHAVNA
Middle Name:
Last Name:MALIK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:BHAVNA
Other - Middle Name:
Other - Last Name:GOMBER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:365 LENNON LN
Mailing Address - Street 2:STE 200
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-5912
Mailing Address - Country:US
Mailing Address - Phone:925-947-2334
Mailing Address - Fax:925-947-5889
Practice Address - Street 1:365 LENNON LN
Practice Address - Street 2:STE 200
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-5912
Practice Address - Country:US
Practice Address - Phone:925-947-2334
Practice Address - Fax:925-947-5889
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2020-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA85469207R00000X, 207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAI45376Medicare UPIN