Healthcare Provider Details

I. General information

NPI: 1417887670
Provider Name (Legal Business Name): BRIGHTLIFE MEDICAL GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2026
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4318 W VICTORY BLVD
BURBANK CA
91505-1334
US

IV. Provider business mailing address

4318 W VICTORY BLVD
BURBANK CA
91505-1334
US

V. Phone/Fax

Practice location:
  • Phone: 504-338-6596
  • Fax:
Mailing address:
  • Phone: 504-338-6596
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code202D00000X
TaxonomyIntegrative Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: SUSHIL PRABAKARAN ANAND
Title or Position: PRESIDENT
Credential: MD
Phone: 504-338-6596