Healthcare Provider Details

I. General information

NPI: 1952214470
Provider Name (Legal Business Name): BINISA BHATTARAI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/25/2026
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

408 W GLADSTONE ST APT 68
GLENDORA CA
91740-5505
US

IV. Provider business mailing address

408 W GLADSTONE ST APT 68
GLENDORA CA
91740-5505
US

V. Phone/Fax

Practice location:
  • Phone: 626-428-5343
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number95373728
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: