Provider Demographics
NPI:1609087014
Name:BHIMANI MEDICAL CORPORATION
Entity Type:Organization
Organization Name:BHIMANI MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BHARAT
Authorized Official - Middle Name:K
Authorized Official - Last Name:BHIMANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-202-5021
Mailing Address - Street 1:1310 W STEWART DR STE 305
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-3838
Mailing Address - Country:US
Mailing Address - Phone:714-202-5021
Mailing Address - Fax:714-202-5170
Practice Address - Street 1:1310 W STEWART DR STE 305
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-3838
Practice Address - Country:US
Practice Address - Phone:714-202-5021
Practice Address - Fax:714-202-5170
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-25
Last Update Date:2013-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC37944208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00C379440Medicaid
CAW7251Medicare ID - Type Unspecified
CA00C379440Medicaid