Healthcare Provider Details

I. General information

NPI: 1689452781
Provider Name (Legal Business Name): MINAL BHATIA MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2023
Last Update Date: 09/19/2023
Certification Date: 09/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40886 GOODWIN WAY
MADERA CA
93636-9900
US

IV. Provider business mailing address

8839 N CEDAR AVE STE 364
FRESNO CA
93720-1832
US

V. Phone/Fax

Practice location:
  • Phone: 559-603-6000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MINAL DEEP BHATIA
Title or Position: PRESIDENT/PSYCHIATRIST
Credential: MD
Phone: 559-905-9061