Provider Demographics
NPI:1669466439
Name:BHANDARI, ANIL KUMAR (MD)
Entity Type:Individual
Prefix:DR
First Name:ANIL
Middle Name:KUMAR
Last Name:BHANDARI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1245 WILSHIRE BLVD STE 580
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90017-5854
Mailing Address - Country:US
Mailing Address - Phone:213-977-0419
Mailing Address - Fax:213-977-0225
Practice Address - Street 1:1245 WILSHIRE BLVD
Practice Address - Street 2:STE 703
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90017-4810
Practice Address - Country:US
Practice Address - Phone:213-977-7422
Practice Address - Fax:213-250-8945
Is Sole Proprietor?:No
Enumeration Date:2005-09-07
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA39656207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
060019747OtherMEDICARE RAILRAOD
CA00A396560Medicaid
060019747OtherMEDICARE RAILRAOD
CAWA39656BMedicare ID - Type Unspecified