Provider Demographics
NPI:1821795329
Name:NUTAN BHASKAR MD INC
Entity Type:Organization
Organization Name:NUTAN BHASKAR MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:NUTAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BHASKAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:626-914-6521
Mailing Address - Street 1:1575 ASHWOOD CT
Mailing Address - Street 2:
Mailing Address - City:UPLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91784-1743
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:415 W CARROLL AVE STE 100
Practice Address - Street 2:
Practice Address - City:GLENDORA
Practice Address - State:CA
Practice Address - Zip Code:91741-4208
Practice Address - Country:US
Practice Address - Phone:626-914-5219
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-14
Last Update Date:2023-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty