Healthcare Provider Details

I. General information

NPI: 1548134257
Provider Name (Legal Business Name): ABHISHEK BHARDWAJ, MD CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2025
Last Update Date: 10/04/2025
Certification Date: 10/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9940 TALBERT AVE STE 101
FOUNTAIN VALLEY CA
92708-5153
US

IV. Provider business mailing address

9940 TALBERT AVE STE 101
FOUNTAIN VALLEY CA
92708-5153
US

V. Phone/Fax

Practice location:
  • Phone: 714-545-8700
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number
License Number State

VIII. Authorized Official

Name: ABHISHEK BHARDWAJ
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: MD
Phone: 267-648-9213