Healthcare Provider Details

I. General information

NPI: 1003566548
Provider Name (Legal Business Name): PARITA BHALODIA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2022
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2299 MOWRY AVE STE 3B
FREMONT CA
94538-1621
US

IV. Provider business mailing address

40910 FREMONT BLVD
FREMONT CA
94538-4375
US

V. Phone/Fax

Practice location:
  • Phone: 510-770-8040
  • Fax:
Mailing address:
  • Phone: 510-770-8040
  • Fax: 510-770-8141

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA206790
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number125.080250
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: