Provider Demographics
NPI:1356538060
Name:BHATT, NANDAN (DR)
Entity type:Individual
Prefix:
First Name:NANDAN
Middle Name:
Last Name:BHATT
Suffix:
Gender:M
Credentials:DR
Other - Prefix:DR
Other - First Name:KUKKEMANE
Other - Middle Name:R
Other - Last Name:BHATT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:26501 AVENUE 140
Mailing Address - Street 2:P.O. BOX 2000
Mailing Address - City:PORTERVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:93257-9109
Mailing Address - Country:US
Mailing Address - Phone:559-782-2222
Mailing Address - Fax:
Practice Address - Street 1:26501 AVENUE 140
Practice Address - Street 2:
Practice Address - City:PORTERVILLE
Practice Address - State:CA
Practice Address - Zip Code:93257-9109
Practice Address - Country:US
Practice Address - Phone:559-782-2222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-26
Last Update Date:2007-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA56494208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice