Provider Demographics
NPI:1659576544
Name:BHATIA, SUNDEEP (MD)
Entity Type:Individual
Prefix:DR
First Name:SUNDEEP
Middle Name:
Last Name:BHATIA
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 1:4940 VAN NUYS BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91403-1700
Mailing Address - Country:US
Mailing Address - Phone:818-528-1260
Mailing Address - Fax:818-528-1261
Practice Address - Street 1:4940 VAN NUYS BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91403-1700
Practice Address - Country:US
Practice Address - Phone:818-528-1260
Practice Address - Fax:818-528-1261
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-19
Last Update Date:2009-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA87935207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease