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General NPI Number Information
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NPI Number | 1114029329
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Entity Type | Individual
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Provider Name | ADITI BHADURI M.D.
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Gender | Female
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Dates
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Enumeration Date | 09/01/2006
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Last Update Date | 06/16/2018
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Provider Practice Location Address
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Address Line | 2510 DOUGLAS BLVD STE 300
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City | ROSEVILLE
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State | CA
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Zip | 95661-3302
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Country | US
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Telephone | 916-746-2343
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Fax |
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Provider Business Mailing Address
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Address Line | 3021 VITTORIA LOOP
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City | DUBLIN
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State | CA
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Zip | 94568-2576
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Country | US
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Telephone | 209-566-0029
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | C55649
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | 045852
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License Number State | GA
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