Provider Demographics
NPI:1750419230
Name:BHARDWAJ, PRITI (MD)
Entity type:Individual
Prefix:DR
First Name:PRITI
Middle Name:
Last Name:BHARDWAJ
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 1:3151 AIRWAY AVE STE G1
Mailing Address - Street 2:
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92626-4624
Mailing Address - Country:US
Mailing Address - Phone:714-545-5550
Mailing Address - Fax:714-708-2588
Practice Address - Street 1:999 N TUSTIN AVE STE 216
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-6506
Practice Address - Country:US
Practice Address - Phone:714-545-5550
Practice Address - Fax:949-609-0374
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA944792084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry