Provider Demographics
NPI:1457546913
Name:BHAVSAR, KALPESH BHIKHALAL (MD)
Entity Type:Individual
Prefix:
First Name:KALPESH
Middle Name:BHIKHALAL
Last Name:BHAVSAR
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:PO BOX 2008
Mailing Address - Street 2:
Mailing Address - City:COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91722-8008
Mailing Address - Country:US
Mailing Address - Phone:619-583-0747
Mailing Address - Fax:619-583-2729
Practice Address - Street 1:4619 ROSEMEAD BLVD
Practice Address - Street 2:
Practice Address - City:ROSEMEAD
Practice Address - State:CA
Practice Address - Zip Code:91770-1478
Practice Address - Country:US
Practice Address - Phone:619-583-0747
Practice Address - Fax:619-583-2729
Is Sole Proprietor?:No
Enumeration Date:2007-09-07
Last Update Date:2013-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1110702084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADM425ZMedicare PIN