Healthcare Provider Details

I. General information

NPI: 1538344205
Provider Name (Legal Business Name): BHUVAN MARTIN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BHUVAN PATHAK M.D.

II. Dates (important events)

Enumeration Date: 12/31/2007
Last Update Date: 03/31/2022
Certification Date: 03/31/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 ALESSANDRO PL STE 210
PASADENA CA
91105-4005
US

IV. Provider business mailing address

50 ALESSANDRO PL STE 210
PASADENA CA
91105-4005
US

V. Phone/Fax

Practice location:
  • Phone: 626-514-0060
  • Fax: 626-514-0062
Mailing address:
  • Phone: 626-514-0060
  • Fax: 626-514-0062

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberA99806
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberA99806
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License NumberA99806
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: