Healthcare Provider Details

I. General information

NPI: 1316904725
Provider Name (Legal Business Name): KALEYATHODI NARAS BHAT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/28/2006
Last Update Date: 12/20/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2182 EAST ST
CONCORD CA
94520-2012
US

IV. Provider business mailing address

2182 EAST ST
CONCORD CA
94520-2012
US

V. Phone/Fax

Practice location:
  • Phone: 925-685-4224
  • Fax: 925-685-6997
Mailing address:
  • Phone: 925-685-4224
  • Fax: 925-685-6997

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License NumberA25677
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: