Healthcare Provider Details

I. General information

NPI: 1174369599
Provider Name (Legal Business Name): RICHA BHATIA MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/04/2024
Last Update Date: 07/04/2024
Certification Date: 07/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3900 NEWPARK MALL STE 205A
NEWARK CA
94560-5243
US

IV. Provider business mailing address

3900 NEWPARK MALL STE 205A
NEWARK CA
94560-5243
US

V. Phone/Fax

Practice location:
  • Phone: 510-588-1135
  • Fax:
Mailing address:
  • Phone: 510-588-1135
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: RICHA BHATIA
Title or Position: CEO
Credential: MD
Phone: 510-903-7622