Provider Demographics
NPI:1679892004
Name:ADHIKARI, PRABHAT
Entity Type:Individual
Prefix:
First Name:PRABHAT
Middle Name:
Last Name:ADHIKARI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4258 W FIGARDEN DR
Mailing Address - Street 2:APT 216
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93722-8611
Mailing Address - Country:US
Mailing Address - Phone:718-715-5085
Mailing Address - Fax:
Practice Address - Street 1:1180 E SHAW AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-7812
Practice Address - Country:US
Practice Address - Phone:559-228-4222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-25
Last Update Date:2012-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CAA119498208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program