Provider Demographics
NPI:1730653080
Name:BHAKTA, NIHAR
Entity Type:Individual
Prefix:
First Name:NIHAR
Middle Name:
Last Name:BHAKTA
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 1:3430 SITIO SANDIA
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92009-8483
Mailing Address - Country:US
Mailing Address - Phone:310-980-9777
Mailing Address - Fax:
Practice Address - Street 1:3430 SITIO SANDIA
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92009-8483
Practice Address - Country:US
Practice Address - Phone:310-980-9777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-18
Last Update Date:2019-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA828992080P0210X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0210XAllopathic & Osteopathic PhysiciansPediatricsPediatric Nephrology