Healthcare Provider Details

I. General information

NPI: 1457967804
Provider Name (Legal Business Name): NIRMALA VISION PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2020
Last Update Date: 11/15/2024
Certification Date: 11/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

999 N TUSTIN AVE STE 219
SANTA ANA CA
92705-6506
US

IV. Provider business mailing address

999 N TUSTIN AVE STE 219
SANTA ANA CA
92705-6506
US

V. Phone/Fax

Practice location:
  • Phone: 714-541-4185
  • Fax: 714-541-3465
Mailing address:
  • Phone: 714-541-4185
  • Fax: 714-541-3465

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207WX0009X
TaxonomyGlaucoma Specialist (Ophthalmology) Physician
License Number
License Number State

VIII. Authorized Official

Name: ANAND BIPIN BHATT
Title or Position: PHYSICIAN
Credential:
Phone: 863-835-1689