Healthcare Provider Details

I. General information

NPI: 1447506142
Provider Name (Legal Business Name): DIABETES AND ENDOCRINOLOGY SPECIALISTS INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2012
Last Update Date: 05/13/2015
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: 925-685-4228
  • Fax: 925-685-6997
Mailing address:
  • Phone: 925-685-4228
  • Fax: 925-685-6997

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License NumberA103188
License Number StateCA

VIII. Authorized Official

Name: DR. ANITA BHAT
Title or Position: OWNER
Credential: M.D.
Phone: 925-685-4228