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General NPI Number Information
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NPI Number | 1609441476
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Entity Type | Organization
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Legal Business Name | ETANNANA IN PATIENT SERVICE INC.
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Dates
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Enumeration Date | 05/24/2021
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Last Update Date | 05/24/2021
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Provider Practice Location Address
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Address Line | 3330 LOMITA BLVD
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City | TORRANCE
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State | CA
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Zip | 90505-5002
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Country | US
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Telephone | 310-325-9110
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Fax |
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Provider Business Mailing Address
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Address Line | 191 W JENNIFER DR
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City | IMPERIAL
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State | CA
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Zip | 92251-8845
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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. BHUWAN SHARMA
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Credential | MD
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Telephone | 858-349-6446
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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