Provider Demographics
NPI:1841504958
Name:BHAMBHANI, SUNDEEP (OD)
Entity type:Individual
Prefix:DR
First Name:SUNDEEP
Middle Name:
Last Name:BHAMBHANI
Suffix:
Gender:M
Credentials:OD
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 190
Mailing Address - Street 2:
Mailing Address - City:BUENA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90621-0190
Mailing Address - Country:US
Mailing Address - Phone:714-228-1888
Mailing Address - Fax:714-676-8308
Practice Address - Street 1:19038 NORWALK BLVD
Practice Address - Street 2:
Practice Address - City:ARTESIA
Practice Address - State:CA
Practice Address - Zip Code:90701-7032
Practice Address - Country:US
Practice Address - Phone:562-653-9500
Practice Address - Fax:562-653-9513
Is Sole Proprietor?:No
Enumeration Date:2010-07-30
Last Update Date:2025-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13912152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist