Provider Demographics
NPI:1730284464
Name:BHARUCHA, PARIMAL T (MD)
Entity Type:Individual
Prefix:
First Name:PARIMAL
Middle Name:T
Last Name:BHARUCHA
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 1:3400 DATA DR
Mailing Address - Street 2:
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95670-7956
Mailing Address - Country:US
Mailing Address - Phone:916-816-1486
Mailing Address - Fax:
Practice Address - Street 1:6555 COYLE AVE STE 215
Practice Address - Street 2:
Practice Address - City:CARMICHAEL
Practice Address - State:CA
Practice Address - Zip Code:95608-0303
Practice Address - Country:US
Practice Address - Phone:916-536-2442
Practice Address - Fax:916-536-2598
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2020-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA112785207R00000X, 207RP1001X, 208M00000X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJP00765888OtherRR MEDICARE
NJ0117722Medicaid
NJ104610Medicare PIN
NJI 63840Medicare UPIN