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General NPI Number Information
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NPI Number | 1902420813
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Entity Type | Individual
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Provider Name | KUNAL KRISHAN BHAN DPM
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Gender | Male
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Dates
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Enumeration Date | 06/05/2020
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Last Update Date | 04/07/2025
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Provider Practice Location Address
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Address Line | 1325 N ANAHEIM BLVD STE 200
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City | ANAHEIM
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State | CA
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Zip | 92801-1202
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Country | US
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Telephone | 888-499-9303
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Fax |
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Provider Business Mailing Address
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Address Line | 10411 BYRNE AVE
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City | CUPERTINO
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State | CA
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Zip | 95014-2813
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Country | US
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Telephone | 408-431-9993
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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 | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 5951001391
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 0103301386
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | E6076
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License Number State | CA
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