Provider Demographics
NPI:1982967196
Name:BHALODIA, ANIL C
Entity Type:Individual
Prefix:MR
First Name:ANIL
Middle Name:C
Last Name:BHALODIA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3378 S BRISTOL ST
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92704-8203
Mailing Address - Country:US
Mailing Address - Phone:714-317-7263
Mailing Address - Fax:
Practice Address - Street 1:3378 S BRISTOL ST
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92704-8203
Practice Address - Country:US
Practice Address - Phone:714-755-7002
Practice Address - Fax:714-755-7613
Is Sole Proprietor?:No
Enumeration Date:2012-06-21
Last Update Date:2022-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA50778183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist