Provider Demographics
NPI:1952668519
Name:BADYAL, HARDEEP (PA-C)
Entity Type:Individual
Prefix:
First Name:HARDEEP
Middle Name:
Last Name:BADYAL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1415 N ACACIA AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:REEDLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93654-2449
Mailing Address - Country:US
Mailing Address - Phone:559-638-8187
Mailing Address - Fax:559-638-3883
Practice Address - Street 1:1415 N ACACIA AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:REEDLEY
Practice Address - State:CA
Practice Address - Zip Code:93654-2449
Practice Address - Country:US
Practice Address - Phone:559-638-8187
Practice Address - Fax:559-638-3883
Is Sole Proprietor?:No
Enumeration Date:2012-04-19
Last Update Date:2012-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA21840363A00000X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPA 21840OtherPHYSICIAN ASSISTANT