Healthcare Provider Details

I. General information

NPI: 1841326477
Provider Name (Legal Business Name): BHARTI H NACHNANI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/26/2007
Last Update Date: 08/13/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1670 E 120TH ST
LOS ANGELES CA
90059-3026
US

IV. Provider business mailing address

1670 E 120TH ST
LOS ANGELES CA
90059-3026
US

V. Phone/Fax

Practice location:
  • Phone: 424-338-1475
  • Fax: 310-223-0361
Mailing address:
  • Phone: 424-338-1475
  • Fax: 310-223-0361

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA53461
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: