Healthcare Provider Details

I. General information

NPI: 1124372347
Provider Name (Legal Business Name): PRIYA BHAKHRI TANDON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/09/2012
Last Update Date: 01/12/2026
Certification Date: 01/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6001 E WASHINGTON BLVD STE 100
COMMERCE CA
90040-2451
US

IV. Provider business mailing address

6001 E WASHINGTON BLVD STE 100
COMMERCE CA
90040-2451
US

V. Phone/Fax

Practice location:
  • Phone: 562-928-9600
  • Fax: 323-477-1738
Mailing address:
  • Phone: 562-928-9600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA123594
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: