Healthcare Provider Details

I. General information

NPI: 1164489159
Provider Name (Legal Business Name): BIMLESH GARG MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/26/2006
Last Update Date: 06/24/2024
Certification Date: 06/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1135 S SUNSET AVE STE 401
WEST COVINA CA
91790-3921
US

IV. Provider business mailing address

3191 HALSEY CT
WEST COVINA CA
91791-3485
US

V. Phone/Fax

Practice location:
  • Phone: 626-962-8451
  • Fax: 626-962-8408
Mailing address:
  • Phone: 267-328-3916
  • Fax: 877-991-6709

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA41524
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: