Provider Demographics
NPI:1821795329
Name:NUTAN BHASKAR MD INC
Entity type:Organization
Organization Name:NUTAN BHASKAR MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:NUTAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BHASKAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:626-914-5219
Mailing Address - Street 1:154A W FOOTHILL BLVD # 281
Mailing Address - Street 2:
Mailing Address - City:UPLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91786-3847
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:353 W FOOTHILL BLVD
Practice Address - Street 2:
Practice Address - City:GLENDORA
Practice Address - State:CA
Practice Address - Zip Code:91741-5309
Practice Address - Country:US
Practice Address - Phone:626-914-5219
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-14
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty