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General NPI Number Information
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NPI Number | 1174972269
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Entity Type | Organization
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Legal Business Name | BHAKTA OPTOMETRIC, PC
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Dates
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Enumeration Date | 06/09/2016
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Last Update Date | 08/01/2022
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Provider Practice Location Address
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Address Line | 1328 XAVIER AVE
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City | HAYWARD
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State | CA
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Zip | 94545-2040
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Country | US
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Telephone | 309-269-1073
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Fax |
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Provider Business Mailing Address
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Address Line | 1645 INDUSTRIAL PKWY W
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City | HAYWARD
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State | CA
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Zip | 94544-7046
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. MEERAL R BHAKTA
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Credential | OD
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Telephone | 309-269-1073
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 14748TLG
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License Number State | CA
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