Provider Demographics
NPI:1740660133
Name:BHASIN, VRINDA (MD)
Entity type:Individual
Prefix:
First Name:VRINDA
Middle Name:
Last Name:BHASIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27799 MEDICAL CENTER RD STE 460
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-6400
Mailing Address - Country:US
Mailing Address - Phone:949-365-2387
Mailing Address - Fax:
Practice Address - Street 1:27799 MEDICAL CENTER RD STE 460
Practice Address - Street 2:
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-6400
Practice Address - Country:US
Practice Address - Phone:949-365-2387
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-01
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA10675200207R00000X
CAA172432207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine