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General NPI Number Information
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NPI Number | 1386989085
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Entity Type | Individual
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Provider Name | MARIUM BHANGDA N.P.
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Gender | Female
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Dates
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Enumeration Date | 12/06/2012
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Last Update Date | 04/04/2025
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Provider Practice Location Address
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Address Line | 710 N EUCLID ST
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City | ANAHEIM
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State | CA
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Zip | 92801-4122
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Country | US
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Telephone | 714-517-2100
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Fax | 714-560-7678
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Provider Business Mailing Address
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Address Line | 886 VENETO
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City | IRVINE
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State | CA
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Zip | 92614-5968
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Country | US
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Telephone | 407-924-9812
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 781264
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 22726
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License Number State | CA
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